Provider Demographics
NPI:1316116296
Name:TITUS, SUSAN MOHN (RN)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:MOHN
Last Name:TITUS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4105 APULIA RD
Mailing Address - Street 2:
Mailing Address - City:JAMESVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13078-9314
Mailing Address - Country:US
Mailing Address - Phone:315-469-6681
Mailing Address - Fax:
Practice Address - Street 1:400 KIMBER RD
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13224-1836
Practice Address - Country:US
Practice Address - Phone:315-446-9011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-26
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY268935-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health