Provider Demographics
NPI:1346049145
Name:NENDZE, SUSANNAH COLE (LM)
Entity type:Individual
Prefix:
First Name:SUSANNAH
Middle Name:COLE
Last Name:NENDZE
Suffix:
Gender:
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:582 W RUSK LN
Mailing Address - Street 2:
Mailing Address - City:LECANTO
Mailing Address - State:FL
Mailing Address - Zip Code:34461-8031
Mailing Address - Country:US
Mailing Address - Phone:352-697-1583
Mailing Address - Fax:207-888-0335
Practice Address - Street 1:582 W RUSK LN
Practice Address - Street 2:
Practice Address - City:LECANTO
Practice Address - State:FL
Practice Address - Zip Code:34461-8031
Practice Address - Country:US
Practice Address - Phone:352-697-1583
Practice Address - Fax:207-888-0335
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW464176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife