Provider Demographics
NPI:1235483413
Name:NESBITT, SUSAN CHARLENE (CNS)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:CHARLENE
Last Name:NESBITT
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68518 BANNOCK RD
Mailing Address - Street 2:BOX 504
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-9736
Mailing Address - Country:US
Mailing Address - Phone:740-695-5169
Mailing Address - Fax:740-695-4010
Practice Address - Street 1:68518 BANNOCK RD
Practice Address - Street 2:BOX 504
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-9736
Practice Address - Country:US
Practice Address - Phone:740-695-5169
Practice Address - Fax:740-695-4010
Is Sole Proprietor?:No
Enumeration Date:2012-11-09
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.04052-NS364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist