Provider Demographics
NPI:1194269324
Name:SUTTON, CATHERINE MARIE (LPN)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:MARIE
Last Name:SUTTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8145 MAPLE GROVE RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49073-9595
Mailing Address - Country:US
Mailing Address - Phone:269-830-8175
Mailing Address - Fax:
Practice Address - Street 1:8145 MAPLE GROVE RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:MI
Practice Address - Zip Code:49073-9595
Practice Address - Country:US
Practice Address - Phone:269-830-8175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703116018164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse