Provider Demographics
NPI:1457507030
Name:SUITS, JOAN Z (NP)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:Z
Last Name:SUITS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:HOUGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:49931-2271
Mailing Address - Country:US
Mailing Address - Phone:906-487-1710
Mailing Address - Fax:
Practice Address - Street 1:301 W LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:HOUGHTON
Practice Address - State:MI
Practice Address - Zip Code:49931-2271
Practice Address - Country:US
Practice Address - Phone:906-487-1710
Practice Address - Fax:906-487-9421
Is Sole Proprietor?:No
Enumeration Date:2008-08-14
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704200963363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner