Individual
MRS. SUSAN AMY BERGDOLL-FAYKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, CPNP
Contact information
Practice address
693 MAIN ST, LUMBERTON, NJ 08048-5043
(609) 261-4058
(609) 261-8381
Mailing address
141 PINE VALLEY RD, CHERRY HILL, NJ 08034-2816
(609) 261-4058
(609) 261-8381
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
26NN06050200
NJ
363LP0200X
Pediatric Nurse Practitioner
Primary
26NN06050200
NJ
Other
Enumeration date
06/05/2008
Last updated
06/20/2023
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