Provider Demographics
NPI:1154127959
Name:GAUTHIER, SUZANNE MARY (RN)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:MARY
Last Name:GAUTHIER
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 UNION ST UNIT 303
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-2858
Mailing Address - Country:US
Mailing Address - Phone:774-766-1606
Mailing Address - Fax:
Practice Address - Street 1:10 RED FOX RUN
Practice Address - Street 2:
Practice Address - City:WRENTHAM
Practice Address - State:MA
Practice Address - Zip Code:02093-2129
Practice Address - Country:US
Practice Address - Phone:774-766-1606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN229I7054163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health