Sussanah Tabot, LPN

Individual provider Active NPI Licensed Practical Nurse · Ann Arbor, MI

NPI 1902277072 · NPPES record last updated Oct 14, 2015

Key facts

NPI
1902277072
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
4703098155 (MI)
Practice address
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone
(734) 936-4000
NPI assigned
Oct 14, 2015
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4703098155MIMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
A Heart That Cares, LLC Current
since Jun 22, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703098155 MI Yes

Addresses

Primary practice location

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000

Mailing address

7145 Colchester LN
Ypsilanti, MI 48197-1871
Phone (678) 777-9767

Other providers in Ann Arbor, MI

All providers in Ann Arbor, MI · Licensed Practical Nurse in Michigan

Sources for this page

Verify at the official NPI Registry.