Wilson, Susan R

Wilson, Susan R is an individual health care provider with primary practice located at 463 E Circle Dr , East Lansing MI 48824-7500. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Wilson, Susan R can be contacted via phone (517) 884-6546.

Contact Information

Primary practice address
463 E Circle Dr East Lansing MI 48824-7500
Phone: (517) 884-6546
Fax: (517) 432-9460
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 4704149259 Michigan

Profile Details

NPI number 1801119532
LBN Legal business name Wilson, Susan R
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 9th, 2010
Last updated Jun 8th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801119532 NPPES
Michigan MEDICAID 1801119532

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