Provider Demographics
NPI:1760223051
Name:MCCUNE, SUE
Entity type:Individual
Prefix:
First Name:SUE
Middle Name:
Last Name:MCCUNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1094 CLEMENT AVE APT C
Mailing Address - Street 2:
Mailing Address - City:BELPRE
Mailing Address - State:OH
Mailing Address - Zip Code:45714-9803
Mailing Address - Country:US
Mailing Address - Phone:304-777-8266
Mailing Address - Fax:
Practice Address - Street 1:1094 CLEMENT AVE APT C
Practice Address - Street 2:
Practice Address - City:BELPRE
Practice Address - State:OH
Practice Address - Zip Code:45714-9803
Practice Address - Country:US
Practice Address - Phone:304-777-8266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide