Basic Information
| Provider Information | |||||||||
| NPI: | 1609395425 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SUTTER | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 835 SWEITZER ST | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 453311077 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9375696996 | ||||||||
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| Practice Location | |||||||||
| Address1: | 622 E ELM ST | ||||||||
| Address2: | |||||||||
| City: | UNION CITY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 453901722 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9379687416 | ||||||||
| FaxNumber: | 9379683026 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2017 | ||||||||
| LastUpdateDate: | 09/29/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | APRN.CNP.021797 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.