Provider Demographics
NPI:1396757811
Name:WILSON, SUSAN J (RN,APN-C)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:J
Last Name:WILSON
Suffix:
Gender:F
Credentials:RN,APN-C
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Mailing Address - Street 1:210 SOUTH SHORE ROAD, SUITE 106
Mailing Address - Street 2:HOPE COMMUNITY CANCER CENTER
Mailing Address - City:MARMORA
Mailing Address - State:NJ
Mailing Address - Zip Code:08223-1271
Mailing Address - Country:US
Mailing Address - Phone:609-390-7888
Mailing Address - Fax:609-390-2614
Practice Address - Street 1:210 SOUTH SHORE ROAD, SUITE 106
Practice Address - Street 2:HOPE COMMUNITY CANCER CENTER
Practice Address - City:MARMORA
Practice Address - State:NJ
Practice Address - Zip Code:08223-1271
Practice Address - Country:US
Practice Address - Phone:609-390-7888
Practice Address - Fax:609-390-2614
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2010-09-27
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Provider Licenses
StateLicense IDTaxonomies
NJ26NC07654700364SX0200X
NJ26NR076554700364SX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology