Provider Demographics
NPI:1508034364
Name:BOISNIER, SUSAN EVE (NURSE PRAC APN C)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:EVE
Last Name:BOISNIER
Suffix:
Gender:F
Credentials:NURSE PRAC APN C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 MADISON AVE
Mailing Address - Street 2:M-WEO-01
Mailing Address - City:MADISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07940-1099
Mailing Address - Country:US
Mailing Address - Phone:973-443-8535
Mailing Address - Fax:973-443-8174
Practice Address - Street 1:285 MADISON AVE
Practice Address - Street 2:M-WEO-01 STUDENT HEALTH
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-1099
Practice Address - Country:US
Practice Address - Phone:973-443-8535
Practice Address - Fax:973-443-8174
Is Sole Proprietor?:No
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ058733163WC1400X
NJ26NJ00117400363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1400XNursing Service ProvidersRegistered NurseCollege Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health