Provider Demographics
NPI:1437200995
Name:YEAGER, SUSAN CAROL (APRN-CNP)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:CAROL
Last Name:YEAGER
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD
Mailing Address - Street 2:SUITE 570
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-366-8012
Mailing Address - Fax:614-685-6492
Practice Address - Street 1:460 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1240
Practice Address - Country:US
Practice Address - Phone:614-366-8012
Practice Address - Fax:614-685-6492
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.07352363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP01686407OtherRAILROAD MEDICARE
OH2813745Medicaid
OHP01603935OtherRAILROAD MEDICARE
OH2813745Medicaid
OHP01686407OtherRAILROAD MEDICARE