Individual
EVGENIA PAVLOVNA SUTTLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
530 S JACKSON ST, LOUISVILLE, KY 40202-1675
(502) 852-5851
(502) 852-3762
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0328
(502) 587-4784
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3015695
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300047572
—
IN
05
—
7100721510
—
KY
Enumeration date
09/28/2020
Last updated
02/23/2021
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