Provider Demographics
NPI:1972830941
Name:SHUSTER, SUZETTE ELYNE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:SUZETTE
Middle Name:ELYNE
Last Name:SHUSTER
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 1:622 EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:NEW LEXINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43764-9698
Mailing Address - Country:US
Mailing Address - Phone:740-343-0760
Mailing Address - Fax:
Practice Address - Street 1:622 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:NEW LEXINGTON
Practice Address - State:OH
Practice Address - Zip Code:43764-9698
Practice Address - Country:US
Practice Address - Phone:740-343-0760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0102593146M00000X
OHPN132703164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate