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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

SUSAN HEATHER LAKE, AGNP

Active Sole Proprietor

SUSAN HEATHER LAKE, AGNP is a Gerontological Nurse Practitioner healthcare provider located in TRENTON, New Jersey. NPI 1790255941 is currently active in the NPPES registry. Verify at CMS.

Gerontological Nurse Practitioner · TRENTON, NJ

Registration Details

NPI Number
1790255941
Provider Type
Individual
Gender
Female
NPI Issued
Nov 30, 2018 (7.6746294291299 yrs)
Last Updated
Nov 30, 2018
Licenses
26NJ00877500 (NJ)
26NJ00877500 (NJ)
Sole Proprietor
Yes

Practice Information

Address
1618 RIVERSIDE DRIVE
TRENTON, NJ, 08618
Browse NJ providers · Browse ZIP 08618
Phone
6093727754
Primary Specialty
Gerontological Nurse Practitioner
363LG0600X

Other Gerontological Nurse Practitioner Providers in TRENTON, NJ

Name Credential NPI
LINDY J INMAN CRNP 1285056242
RACHEL HUGHES PAN 1770134660
JACQUELENE VERTUS APN 1710511423
ELZBIETA JOANNA KACZMAREK APN 1720738289
GINA NOVILUS NP 1003662545
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.