Provider Demographics
NPI:1740203652
Name:LECATES, SUSAN L (RN, CNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:L
Last Name:LECATES
Suffix:
Gender:F
Credentials:RN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:ML 5021
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3039
Mailing Address - Country:US
Mailing Address - Phone:513-636-4225
Mailing Address - Fax:513-636-2511
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:ML 2015
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3039
Practice Address - Country:US
Practice Address - Phone:513-636-4222
Practice Address - Fax:513-636-3980
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.05510-NP363LP0200X
OHAPRN.CNP.05510363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics