Provider Demographics
NPI:1154365609
Name:SCHUSSLER, SUSAN (RD, RN, CDE)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:
Last Name:SCHUSSLER
Suffix:
Gender:F
Credentials:RD, RN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4431 WINSTON LN S
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34235-3210
Mailing Address - Country:US
Mailing Address - Phone:941-358-6568
Mailing Address - Fax:941-355-0685
Practice Address - Street 1:4431 WINSTON LN S
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34235-3210
Practice Address - Country:US
Practice Address - Phone:941-358-6568
Practice Address - Fax:941-355-0685
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND 4731133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2042-0429OtherCERTIFIED DIABETES EDUCATOR
FLRN 9233611OtherLICENSE
FLND 4731OtherLICENSE