Provider Demographics
NPI:1841453511
Name:ENGLES, SUSAN LYNN (CRNP,APN)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:LYNN
Last Name:ENGLES
Suffix:
Gender:F
Credentials:CRNP,APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 N MAIN ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-2163
Mailing Address - Country:US
Mailing Address - Phone:609-536-8272
Mailing Address - Fax:609-536-8273
Practice Address - Street 1:211 N MAIN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-2163
Practice Address - Country:US
Practice Address - Phone:609-536-8272
Practice Address - Fax:609-536-8273
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009651363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0515884Medicaid
PA1027861860001Medicaid
NJ0515884Medicaid
PA1027861860001Medicaid