Provider Demographics
NPI:1306168927
Name:GUINN, SUSAN LEE (RPH)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:LEE
Last Name:GUINN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:CHEBOYGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49721-2124
Mailing Address - Country:US
Mailing Address - Phone:231-627-7139
Mailing Address - Fax:231-627-5358
Practice Address - Street 1:1131 E STATE ST
Practice Address - Street 2:
Practice Address - City:CHEBOYGAN
Practice Address - State:MI
Practice Address - Zip Code:49721-2124
Practice Address - Country:US
Practice Address - Phone:231-627-7139
Practice Address - Fax:231-627-5358
Is Sole Proprietor?:No
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302022350183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist