Provider Demographics
NPI:1508870692
Name:RUZICH, SUSAN J (CNP)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:J
Last Name:RUZICH
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 AUBURN DR STE 110
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4317
Mailing Address - Country:US
Mailing Address - Phone:216-285-5050
Mailing Address - Fax:
Practice Address - Street 1:1000 AUBURN DR STE 110
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4317
Practice Address - Country:US
Practice Address - Phone:216-285-5050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN241992363LA2200X
OHRN. 241992363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9363683OtherMEDICARE
OH0904749Medicaid