Provider Demographics
NPI:1780687079
Name:COMTE, SUSAN KATHRYN (CNM)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:KATHRYN
Last Name:COMTE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2830 VICTORY PKWY
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-1785
Mailing Address - Country:US
Mailing Address - Phone:513-245-3664
Mailing Address - Fax:513-475-7259
Practice Address - Street 1:234 GOODMAN ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2364
Practice Address - Country:US
Practice Address - Phone:513-584-4081
Practice Address - Fax:513-584-2579
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNM4908367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2264339Medicaid
OHCONM02281Medicare ID - Type Unspecified
OHCONM02282Medicare ID - Type Unspecified
OHP41450Medicare UPIN
OHCONM02283Medicare PIN