Provider Demographics
NPI:1932953742
Name:VENTURINI, SUZETTE LIGAD (AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:SUZETTE
Middle Name:LIGAD
Last Name:VENTURINI
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 E MICHIGAN AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-1855
Mailing Address - Country:US
Mailing Address - Phone:517-205-1642
Mailing Address - Fax:
Practice Address - Street 1:1201 E MICHIGAN AVE STE 200
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1855
Practice Address - Country:US
Practice Address - Phone:517-205-4841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-16
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704354588363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner