Provider Demographics
NPI:1659975753
Name:SUTTON, MARIA NICOLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:NICOLE
Last Name:SUTTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11859 EDGEWATER DR APT 105
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-6719
Mailing Address - Country:US
Mailing Address - Phone:412-908-3272
Mailing Address - Fax:
Practice Address - Street 1:27713 LORAIN RD
Practice Address - Street 2:
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-4019
Practice Address - Country:US
Practice Address - Phone:440-716-5166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03438883183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist