Individual
MRS. SUSAN MARJORIE JENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 STICKLEY DR, MANLIUS, NY 13104-2484
(315) 682-5500
(315) 682-8669
Mailing address
1 STICKLEY DR, PO BOX 480, MANLIUS, NY 13104-2484
(315) 682-5500
(315) 682-8669
Taxonomy
Speciality
Code
Description
License number
State
363LX0106X
Occupational Health Nurse Practitioner
Primary
F301000-1
NY
Other
Enumeration date
11/03/2008
Last updated
11/03/2008
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