Provider Demographics
NPI:1639725179
Name:HAMANN, SUSAN ANN (RN)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:ANN
Last Name:HAMANN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:464 RICHMOND RD STE 202
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-2704
Mailing Address - Country:US
Mailing Address - Phone:330-824-4200
Mailing Address - Fax:440-525-5564
Practice Address - Street 1:464 RICHMOND RD STE 202
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-2704
Practice Address - Country:US
Practice Address - Phone:330-824-4200
Practice Address - Fax:440-525-5564
Is Sole Proprietor?:No
Enumeration Date:2019-08-12
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN124726163WN1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN1003XNursing Service ProvidersRegistered NurseNutrition Support