Individual
SUSAN WILKINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
305 NEWBURY ST STE 41, BOSTON, MA 02115-2833
(617) 600-4235
(617) 608-5899
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118-2371
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
283356
MA
363L00000X
Nurse Practitioner
Primary
RN283356
MA
390200000X
Student in an Organized Health Care Education/Training Program
RN283356
MA
Other
Enumeration date
07/31/2014
Last updated
02/03/2021
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