Provider Demographics
NPI:1750728135
Name:FIX, SUSAN MILDRED (RN BS CDE)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:MILDRED
Last Name:FIX
Suffix:
Gender:F
Credentials:RN BS CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4235 SECOR RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4231
Mailing Address - Country:US
Mailing Address - Phone:419-740-1294
Mailing Address - Fax:888-363-3695
Practice Address - Street 1:9440 BUCHER RD
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE
Practice Address - State:OH
Practice Address - Zip Code:43571-9461
Practice Address - Country:US
Practice Address - Phone:419-740-1294
Practice Address - Fax:888-363-3695
Is Sole Proprietor?:No
Enumeration Date:2013-05-27
Last Update Date:2013-05-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH098902163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator