SUSAN HEATHER LAKE


Address: 1618 Riverside Drive, Trenton, NJ 08618
Phone: 6093727754

SUSAN HEATHER LAKE (NPI# 1790255941) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1790255941
Entity Type Individual
Full Name SUSAN HEATHER LAKE
Credential AGNP
Practice Address 1618 Riverside Drive
Trenton
NJ 08618
Practice Telephone 6093727754
Mailing Telephone 6093727754
Enumeration Date 2018-11-30
Last Update Date 2018-11-30
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363LA2200X Nurse Practitioner
Specialization: Adult Health
26NJ00877500 NJ Physician Assistants & Advanced Practice Nursing Providers
Y 363LG0600X Nurse Practitioner
Specialization: Gerontology
26NJ00877500 NJ Physician Assistants & Advanced Practice Nursing Providers

Other Providers SUSAN LAKE

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1750586582 Susan P. Lake Speech-Language Pathologist 518 Meadow Mountain Dr., 518 Meadow Mountain Dr., Allenspark, CO 80510-0012 2007-06-20
1285687210 Susan Lake Optometrist 601 E Russell Ave, Suite A, Warrensburg, MO 64093-9605 2006-05-19
1962784488 Susan Lake Psychologist 4150 Clement St, 116b, San Francisco, CA 94121-1545 2011-09-10
1366679664 Susan D Lake Registered Nurse 281 Sawyer Dr, Suite 100, Durango, CO 81303-3409 2009-06-15
1306003835 Susan E Lake Family Medicine 4550 N Hamilton Rd, Gahanna, OH 43230-1714 2008-05-21

Office Location

Street Address 1618 RIVERSIDE DRIVE
City TRENTON
State NJ
Zip Code 08618

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
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1497138705 Jennifer Warren Community Health Worker 32 Newell Ave, Trenton, NJ 08618 2015-07-06
1447665500 Avinique Marshall Community Health Worker 23 Van Duyn Dr, Ewing, NJ 08618 2014-06-27
1891116646 Ameen Hasan Abdullah Counselor 132 Perry St., Trenton, NJ 08618 2013-12-20
1083042782 Odelind King Lewis Social Worker 321 North Warren Street, Trenton, NJ 08618 2013-10-16
1346595089 Essential Foot Care PC Clinic/Center 1440 Pennington Road, Ewing, NJ 08618 2012-07-18
1245543453 Beverly M Gibson Counselor 68 Dunmore Avneue, Ewing, NJ 08618 2010-07-16
1386878353 James C Wadley Community/Behavioral Health 312 Masterson Court, Ewing, NJ 08618 2009-05-06
1851537815 Ilse K Thomas Physician Assistant 416 Bellevue Aveune, Suite 104, Trenton, NJ 08618 2008-12-22
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Taxonomy Information

Taxonomy Code 363LG0600X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Gerontology

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1871032557 Theresa Mary Husby Nurse Practitioner 1640 Fort St Ste D, Trenton, MI 48183-2040 2017-02-15
1710511423 Jacquelene Vertus Nurse Practitioner 750 Brunswick Ave, Trenton, NJ 08638-4143 2020-03-03
1770134660 Rachel Hughes Nurse Practitioner 750 Brunswick Ave, Trenton, NJ 08638-4143 2019-09-23
1801458674 Rachel H Adler Nurse Practitioner 750 Bruswick Ave, Trenton, NJ 08638 2019-07-02

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1760098677 Lauren Olmstead Nurse Practitioner 317 George St Ste 440, New Brunswick, NJ 08901-2008 2020-09-17
1275151961 Natacha Jharahy Nurse Practitioner 2194 Stecher Ave, Union, NJ 07083-5252 2020-07-08
1477178424 Dorota Mironiuk Nurse Practitioner 17 Reagan Way, Kinnelon, NJ 07405-2738 2020-06-15
1770111320 Adrian A Sanchez Nurse Practitioner 28 Springbrook Rd E, Montville, NJ 07045-9162 2020-03-30
1356977409 Gayle M Pistilli Nurse Practitioner 271 Cindy St, Old Bridge, NJ 08857-3060 2020-03-20
1578193876 Melonie D Smith Nurse Practitioner 39 E 39th St Apt 4p, Paterson, NJ 07514-1163 2020-01-25
1710529151 Anna M Comayagua Nurse Practitioner 82 Crab Apple Hill Rd, Milford, NJ 08848-1803 2019-10-16
1740830157 Trisha Boland Nurse Practitioner 133 Center St Unit B2, New Milford, NJ 07646-2653 2019-09-17
1881242840 Emily Lott Nurse Practitioner 1865 Rte 70 E, Cherry Hill, NJ 08003 2019-09-03
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Competitor

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City TRENTON
Zip Code 08618

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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