Provider Demographics
NPI:1447586763
Name:PEPE, SUSAN ANN (ANP-BC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:ANN
Last Name:PEPE
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 HOPE RD
Mailing Address - Street 2:BUILDING 5
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-1277
Mailing Address - Country:US
Mailing Address - Phone:732-571-1000
Mailing Address - Fax:732-571-1156
Practice Address - Street 1:615 HOPE RD
Practice Address - Street 2:BUILDING 5
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-1277
Practice Address - Country:US
Practice Address - Phone:732-571-1000
Practice Address - Fax:732-571-1156
Is Sole Proprietor?:No
Enumeration Date:2009-10-21
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00246500363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health