Individual
SUSANNE BODINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1500 JAMES SIMPSON JR WAY, 301, COVINGTON, KY 41011-0801
(859) 655-8910
(859) 655-8911
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 655-8910
(859) 655-8911
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3007630
KY
363LA2100X
Acute Care Nurse Practitioner
3007630
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0072233
—
OH
05
—
7100210530
—
KY
Enumeration date
08/27/2012
Last updated
09/18/2018
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