Provider Demographics
NPI:1285682104
Name:EICHER, SUSAN G (CRNA)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:G
Last Name:EICHER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 FOXHURST DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-1818
Mailing Address - Country:US
Mailing Address - Phone:412-963-0277
Mailing Address - Fax:412-963-0277
Practice Address - Street 1:320 E NORTH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4756
Practice Address - Country:US
Practice Address - Phone:412-359-3131
Practice Address - Fax:412-330-4883
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN241944L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2153244Medicaid
WV5710147000Medicaid
PA901607Medicare PIN
WV5710147000Medicaid
PA901607NHDMedicare PIN