Susan H Lake, AGNP
Nurse Practitioner, Gerontology in Trenton, New Jersey
1790255941- Practice location
- 1618 Riverside Drive, Trenton, NJ 08618
- Phone
- 609-372-7754
- Fax
- —
- Last updated
- November 30, 2018
Susan Heather Lake is a Nurse Practitioner, Gerontology based in Trenton, NJ. Susan Heather Lake practices in Trenton, NJ and has the professional credentials of AGNP. The NPI Number for Susan Heather Lake is 1790255941 and holds a License No. 26NJ00877500 (NJ). The current practice location address for Susan Heather Lake is 1618 Riverside Drive, Trenton, NJ 08618 and can be reached out via phone at 609-372-7754.
Provider Profile Details
- NPI Number
- 1790255941
- Provider Name
- Susan Heather Lake
- Credential
- AGNP
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 1618 Riverside Drive, Trenton, NJ 08618
- Phone Number
- 609-372-7754
- Primary Taxonomy
- Nurse Practitioner, Gerontology · 363LG0600X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- November 30, 2018
- Last Update Date
- November 30, 2018
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1618 Riverside Drive
Trenton, NJ 08618 - City
- Trenton
- State
- New Jersey
- Zip
- 08618
- Phone Number
- 609-372-7754
Provider Business Mailing Address Details
- Address
- 1618 Riverside Drive
Trenton, NJ 08618 - City
- Trenton
- State
- NJ
- Zip
- 08618
- Phone Number
- 609-372-7754
License Information
- License Number (1)
- 26NJ00877500
- License State (1)
- NJ
- Taxonomy (1)
- Nurse Practitioner, Adult Health · 363LA2200X
- License Number (2)
- 26NJ00877500
- License State (2)
- NJ
- Taxonomy (2)
- Nurse Practitioner, Gerontology · 363LG0600X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Susan H Lake, AGNP?
The NPI number of Susan H Lake, AGNP is 1790255941. It was assigned on November 30, 2018 and is currently active in the NPPES registry.
What is the specialty of Susan H Lake, AGNP?
Susan H Lake, AGNP is registered under the primary taxonomy Nurse Practitioner, Gerontology (code 363LG0600X), licensed in NJ under license number 26NJ00877500.
Where does Susan H Lake, AGNP practice?
The practice location is 1618 Riverside Drive, Trenton, NJ 08618. The office can be reached at 609-372-7754 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1790255941 directly on the NPPES registry website.