Provider Demographics
NPI:1396001509
Name:HIOS, PENNYSUE (STNA)
Entity Type:Individual
Prefix:MRS
First Name:PENNYSUE
Middle Name:
Last Name:HIOS
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4223 POE AVE
Mailing Address - Street 2:DN
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-2309
Mailing Address - Country:US
Mailing Address - Phone:216-377-9505
Mailing Address - Fax:
Practice Address - Street 1:4223 POE AVE
Practice Address - Street 2:DN
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-2309
Practice Address - Country:US
Practice Address - Phone:216-377-9505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH324690051202376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide