| Doctor Name: | SUSAN RENEE TUTTLE |
| NPI Number: | 1740286988 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APN |
| License Number: | 209003723 |
| Business Practice Address: | 325 Spring St Red Bud, IL - 622781105 |
| Business Phone Number: | 6182827373 |
| Business Fax Number: | |
| Mailing Address: | 325 Spring St, RED BUD |
| State: | IL |
| Postal Code: | 622781105 |
| Phone Number: | 6182827373 |
| Fax Number: | |
| NPI Enumeration Date: | 06/22/2005 |
| NPI Last Update Date: | 02/10/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 209003723 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |