Provider Demographics
NPI:1750494241
Name:FLOTTEMESCH, SUZANNE A (ARNP)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:A
Last Name:FLOTTEMESCH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4440 RED BANK RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-2176
Mailing Address - Country:US
Mailing Address - Phone:513-564-1366
Mailing Address - Fax:513-564-1367
Practice Address - Street 1:4440 RED BANK RD
Practice Address - Street 2:SUITE 110
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-2176
Practice Address - Country:US
Practice Address - Phone:513-564-1366
Practice Address - Fax:513-564-1367
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH11380363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU4090XMedicare PIN
FLU4090ZMedicare ID - Type Unspecified
FLU409OYMedicare PIN
FLQ33405Medicare UPIN