Provider Demographics
NPI:1619684339
Name:PAXTON, SUSAN
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:PAXTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10411 SEMINOLE SHORE DR
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43324-9529
Mailing Address - Country:US
Mailing Address - Phone:937-545-0205
Mailing Address - Fax:
Practice Address - Street 1:10411 SEMINOLE SHORE DR
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43324-9529
Practice Address - Country:US
Practice Address - Phone:937-545-0205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-02
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care