Suzan Jeanne Ollila, RN
Individual provider Active NPI Registered Nurse · Baraga, MI
NPI 1720174154 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720174154
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 4704185660 (MI)
- Practice address
- 102 Superior Ave
Baraga, MI 49908 - Phone
- (906) 353-8700
- Fax
- (906) 353-8799
- NPI assigned
- Oct 5, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704185660 | MI | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 4704185660 | MI | Yes |
Addresses
Primary practice location
102 Superior Ave
Baraga, MI 49908
Mailing address
102 Superior Ave
Baraga, MI 49908
Phone (906) 353-8700
Other providers in Baraga, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.