Provider Demographics
NPI:1285753830
Name:NEWSWANGER, SUSAN A (APRN, BC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:A
Last Name:NEWSWANGER
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 BACK CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-8843
Mailing Address - Country:US
Mailing Address - Phone:302-376-1336
Mailing Address - Fax:
Practice Address - Street 1:1901 S COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-2377
Practice Address - Country:US
Practice Address - Phone:302-369-1501
Practice Address - Fax:302-369-1503
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG0000139363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily