Provider Demographics
NPI:1356932529
Name:SUSTERSIC, CATHERINE (APRN)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:SUSTERSIC
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 CLAGUE RD STE 2420
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-1582
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:960 CLAGUE RD STE 2420
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-1582
Practice Address - Country:US
Practice Address - Phone:440-646-2211
Practice Address - Fax:440-250-5333
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-01
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0028295363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner