SUSAN WILSON PA-C NPI 1396709804

NPI Information

NPI: 1396709804
Provider Name: SUSAN WILSON, PA-C
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

Address:
1400 E KINCAID ST
MOUNT VERNON, WA
ZIP 98274
Phone: (360) 428-2500
Get Directions

Susan Wilson, PA-C is a pediatrics nurse practitioner in Mount Vernon, WA. Susan Wilson, PA-C NPI is 1396709804. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1400 E KINCAID ST
MOUNT VERNON, WA
ZIP 98274-127
Phone: (360) 428-2500
Fax: (360) 428-6485

The enumeration date for this NPI number is 4/12/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0200X	Nurse Practitioner	Pediatrics	PA10000103	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	P49254	MEDICARE UPIN	WASHINGTON
2	8354672	MEDICAID	WASHINGTON
3	AB26017	MEDICARE ID-TYPE UNSPECIFIED	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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