Provider Demographics
NPI:1356342562
Name:HOLDEN, SUSAN J (CNM)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:J
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2060 READING RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-1454
Mailing Address - Country:US
Mailing Address - Phone:513-721-3200
Mailing Address - Fax:513-639-3186
Practice Address - Street 1:7495 STATE RD
Practice Address - Street 2:STE 300
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-6402
Practice Address - Country:US
Practice Address - Phone:513-231-3447
Practice Address - Fax:513-231-3761
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2015-07-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OHRN156009163W00000X
OHNM1181367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2264339Medicaid
OHP41450Medicare UPIN
OH2264339Medicaid
OHCONM02281Medicare ID - Type Unspecified