Individual
MRS. SUSAN ELIZABETH JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
EDD.,APN-BC
Contact information
Practice address
20 MAIR AVE, TOTOWA, NJ 07512-2313
(973) 256-1732
(973) 256-5497
Mailing address
20 MAIR AVE, TOTOWA, NJ 07512-2313
(973) 256-1732
(973) 256-5497
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ00146900
NJ
Other
Enumeration date
01/12/2008
Last updated
01/12/2008
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