Basic Information
| Provider Information | |||||||||
| NPI: | 1972583458 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOYING | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | L. | ||||||||
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| Credential: | CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3006 N COUNTY ROAD 25A | ||||||||
| Address2: | SUITE 104 | ||||||||
| City: | TROY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 453731373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9373353518 | ||||||||
| FaxNumber: | 9373326857 | ||||||||
| Practice Location | |||||||||
| Address1: | 3006 N COUNTY ROAD 25A | ||||||||
| Address2: | SUITE 104 | ||||||||
| City: | TROY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 453731373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9373353518 | ||||||||
| FaxNumber: | 9373326857 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2006 | ||||||||
| LastUpdateDate: | 08/21/2014 | ||||||||
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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 | 363LA2100X | NP-07845 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
ID Information
| ID | Type | State | Issuer | Description | 0068524 | 05 | OH | MEDICAID |