Provider Demographics
NPI:1235374240
Name:STEWART, SUSAN ANN (RN, FNP-BC)
Entity Type:Individual
Prefix:MISS
First Name:SUSAN
Middle Name:ANN
Last Name:STEWART
Suffix:
Gender:F
Credentials:RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 LAKELAND RD
Mailing Address - Street 2:DIPIERO CENTER, SUITE 536
Mailing Address - City:BLACKWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-2946
Mailing Address - Country:US
Mailing Address - Phone:856-374-6248
Mailing Address - Fax:856-374-6210
Practice Address - Street 1:2631 FEDERAL ST
Practice Address - Street 2:EAST CAMDEN HEALTH CENTER
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08105-1935
Practice Address - Country:US
Practice Address - Phone:856-756-2266
Practice Address - Fax:856-968-2307
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-04
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN04826800363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily