Susan E Wilson
Nurse Practitioner - Neonatal (Critical Care)
616 Smithview Dr
Maryville
, Tennessee 37803-6100
Susan E Wilson
Nurse Practitioner - Neonatal (Critical Care)
616 Smithview Dr
Maryville
, Tennessee 37803-6100
(865) 738-0087
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About
Features
Specialties
- Nurse Practitioner - Neonatal (Critical Care)
Languages spoken
- English
Location
First Address
- Susan E Wilson
- 616 Smithview Dr
- Maryville, TN
- Zip : 37803-6100
- Fax : (865) 738-0087
- Phone : (865) 379-2277
Second Address
- Susan E Wilson
- 616 Smithview Dr
- Maryville, TN
- Zip : 37803-6100
- Fax : (865) 738-0087
- Phone : (865) 379-2277
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | APN12098 | TN |
National Provider Identifier
| NPI | 1336174093 |
|---|---|
| Provider Name | Susan E Wilson |
| First Address | Maryville, TN 37803-6100 |
| Second Address | Maryville, TN 37803-6100 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/07/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 20060525 | BOARD CERTIFICATION # (01) | TN |
| APN0000012098 | ADVANCED PRACTICE ID # (01) | TN |
| MW1425493 | DEA (01) | TN |
| RN0000096921 | RN STATE LICENSE (01) | TN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.