Provider Demographics
NPI:1689706459
Name:HORVATH, SUSAN WESTON (NP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:WESTON
Last Name:HORVATH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 SULLIVANT AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-1837
Mailing Address - Country:US
Mailing Address - Phone:614-655-8956
Mailing Address - Fax:
Practice Address - Street 1:3219 SULLIVANT AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-1837
Practice Address - Country:US
Practice Address - Phone:614-655-8956
Practice Address - Fax:614-748-0569
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.00400363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2360369Medicaid
OH2360369Medicaid