Provider Demographics
NPI:1902845142
Name:CASA, SUZANNE T (CNM)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:T
Last Name:CASA
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:614-566-9989
Mailing Address - Fax:614-566-8423
Practice Address - Street 1:3830 OLENTANGY RIVER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-5404
Practice Address - Country:US
Practice Address - Phone:614-566-9989
Practice Address - Fax:614-566-8423
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHRN197325 NM05717367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2565442Medicaid
OH2565442Medicaid
OHCANM03151Medicare ID - Type Unspecified
OHQ47575Medicare UPIN