Provider Demographics
NPI:1881943199
Name:UJVARI, SUSAN BELLE (LPN)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:BELLE
Last Name:UJVARI
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 1:1661 SAPPHIRE DRIVE
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236
Mailing Address - Country:US
Mailing Address - Phone:330-342-0956
Mailing Address - Fax:
Practice Address - Street 1:1661 SAPPHIRE DRIVE
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236
Practice Address - Country:US
Practice Address - Phone:330-342-0956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-31
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.069561164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse