Basic Information
| Provider Information | |||||||||
| NPI: | 1477979060 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LUTERAN | ||||||||
| FirstName: | SUZANNE | ||||||||
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| Credential: | CNP-FAMILY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 STATE ST | ||||||||
| Address2: | SUITE 400A | ||||||||
| City: | ERIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 165071427 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8148776997 | ||||||||
| FaxNumber: | 8148776356 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 STATE ST | ||||||||
| Address2: | SUITE 400A | ||||||||
| City: | ERIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 165071427 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8148776997 | ||||||||
| FaxNumber: | 8148776356 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2014 | ||||||||
| LastUpdateDate: | 04/30/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | SP013631 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.