Provider Demographics
NPI:1821704016
Name:SUTTER, MICHELLE LORRAINE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:LORRAINE
Last Name:SUTTER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:746 ROBIN DR
Mailing Address - Street 2:
Mailing Address - City:EASTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44095-1615
Mailing Address - Country:US
Mailing Address - Phone:440-251-7572
Mailing Address - Fax:
Practice Address - Street 1:8785 MENTOR AVE
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-6209
Practice Address - Country:US
Practice Address - Phone:440-701-6590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN097111164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse