Provider Demographics
NPI:1588348338
Name:NUTTER, SUSAN (APRN, PMHNP)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:NUTTER
Suffix:
Gender:F
Credentials:APRN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 BYPASS RD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40391-2715
Mailing Address - Country:US
Mailing Address - Phone:859-279-2220
Mailing Address - Fax:
Practice Address - Street 1:1617 BYPASS RD # 144
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-2715
Practice Address - Country:US
Practice Address - Phone:859-279-2220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4004993363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health