Wilson, Susan E

Wilson, Susan E is an individual health care provider with primary practice located at 616 Smithview Dr , Maryville TN 37803-6100. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Critical Care, which is considered as her primary health care specialty. Wilson, Susan E can be contacted via phone (865) 379-2277.

Contact Information

Primary practice address
616 Smithview Dr Maryville TN 37803-6100
Phone: (865) 379-2277
Fax: (865) 738-0087
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Critical Care 363LN0005X APN12098 Tennessee

Profile Details

NPI number 1336174093
LBN Legal business name Wilson, Susan E
Credentials Certified Pediatric Nurse Practitioner (CPNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2006
Last updated Mar 7th, 2023 - about last year

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 1336174093 NPPES
Tennessee Other 20060525 BOARD CERTIFICATION #
Tennessee Other APN0000012098 BOARD CERTIFICATION #
Tennessee Other RN0000096921 BOARD CERTIFICATION #

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