| Doctor Name: | MS. TINA MARIE SUDDUTH |
| NPI Number: | 1134424781 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | REGISTERED NURSE |
| License Number: | 396021 |
| Business Practice Address: | 14191 Yale St Hesperia, CA - 923448290 |
| Business Phone Number: | 9098551545 |
| Business Fax Number: | |
| Mailing Address: | 14191 Yale St, HESPERIA |
| State: | CA |
| Postal Code: | 923448290 |
| Phone Number: | 9098551545 |
| Fax Number: | |
| NPI Enumeration Date: | 01/12/2011 |
| NPI Last Update Date: | 01/12/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WN0003X |
| License Number: | 396021 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Neonatal, Low-Risk |
| Taxonomy Definition: | |