Wilson, Suzanne Victoria

Wilson, Suzanne Victoria is an individual health care provider with primary practice located at 771 Old Norcross Rd Suite 135, Lawrenceville GA 30046-4386. 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, Suzanne Victoria can be contacted via phone (678) 689-1100.

Contact Information

Primary practice address
771 Old Norcross Rd Suite 135 Lawrenceville GA 30046-4386
Phone: (678) 689-1100
Fax: (678) 722-8206
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN159818NP Georgia

Profile Details

NPI number 1326187634
LBN Legal business name Wilson, Suzanne Victoria
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 5th, 2007
Last updated Apr 22nd, 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 1326187634 NPPES
Georgia MEDICAID 525719654A

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