Doctor Name: | MRS. SUSAN LOUISE ACKLEY |
NPI Number: | 1952422347 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN, APN-C |
License Number: | 26NN09155900 |
Business Practice Address: | 63 N Lakeview Dr Ste 202 Gibbsboro, NJ - 080261026 |
Business Phone Number: | 8564356000 |
Business Fax Number: | |
Mailing Address: | 63 N Lakeview Dr Ste 202, GIBBSBORO |
State: | NJ |
Postal Code: | 080261026 |
Phone Number: | 8564356000 |
Fax Number: | |
NPI Enumeration Date: | 04/03/2007 |
NPI Last Update Date: | 08/31/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | 26NN09155900 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |