Provider Demographics
NPI:1467833723
Name:FISHER-BROWN, SUSAN RENEE' (APN)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:RENEE'
Last Name:FISHER-BROWN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 NEW RD STE 201
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1281
Mailing Address - Country:US
Mailing Address - Phone:609-788-8953
Mailing Address - Fax:609-904-6929
Practice Address - Street 1:1 E. NEW YORK AVENUE
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244
Practice Address - Country:US
Practice Address - Phone:609-653-3500
Practice Address - Fax:609-926-4311
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-12
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00557300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily