Provider Demographics
NPI:1891082475
Name:BOND, SUSANNE FICHT (CNP)
Entity Type:Individual
Prefix:MS
First Name:SUSANNE
Middle Name:FICHT
Last Name:BOND
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:THIRD FLOOR BILLING SERVICES
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:330-527-2617
Mailing Address - Fax:330-527-5099
Practice Address - Street 1:10724 SOUTH ST
Practice Address - Street 2:
Practice Address - City:GARRETTSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44231-1111
Practice Address - Country:US
Practice Address - Phone:330-527-2617
Practice Address - Fax:330-527-5099
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH12444363L00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0077842Medicaid