Provider Demographics
NPI:1023452844
Name:REIF, SUSAN E (CNP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:E
Last Name:REIF
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 BRECKSVILLE RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-5057
Mailing Address - Country:US
Mailing Address - Phone:216-444-4663
Mailing Address - Fax:216-636-8839
Practice Address - Street 1:6801 BRECKSVILLE RD
Practice Address - Street 2:SUITE 10
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-5057
Practice Address - Country:US
Practice Address - Phone:216-444-4663
Practice Address - Fax:216-636-8839
Is Sole Proprietor?:No
Enumeration Date:2013-04-23
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH14356363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health