Provider Demographics
NPI:1063721389
Name:PIECYNSKI, SUSAN E (ACNP)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:E
Last Name:PIECYNSKI
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:M
Other - Last Name:ECKLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACNP
Mailing Address - Street 1:10380 PIDCOCK RD
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:OH
Mailing Address - Zip Code:43767-9735
Mailing Address - Country:US
Mailing Address - Phone:256-797-8167
Mailing Address - Fax:
Practice Address - Street 1:751 FOREST AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-2868
Practice Address - Country:US
Practice Address - Phone:740-455-7670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH12019-NP363LA2100X
OH364523163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse