Provider Demographics
NPI:1376892687
Name:COTHRAN, SUZANNE (RNP)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:COTHRAN
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 MCLEAN AVE
Mailing Address - Street 2:SUITE 387
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-4107
Mailing Address - Country:US
Mailing Address - Phone:914-237-6797
Mailing Address - Fax:914-237-6790
Practice Address - Street 1:92 S MAPLE ST
Practice Address - Street 2:
Practice Address - City:HAZEN
Practice Address - State:AR
Practice Address - Zip Code:72064-8203
Practice Address - Country:US
Practice Address - Phone:870-255-4323
Practice Address - Fax:870-255-4910
Is Sole Proprietor?:No
Enumeration Date:2012-08-31
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR29161163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care