SUSAN HEATHER LAKE (NPI# 1790255941) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790255941 |
| Entity Type | Individual |
| Full Name | SUSAN HEATHER LAKE |
| Credential | AGNP |
| Practice Address |
1618 Riverside Drive Trenton NJ 08618 |
| Practice Telephone | 6093727754 |
| Mailing Telephone | 6093727754 |
| Enumeration Date | 2018-11-30 |
| Last Update Date | 2018-11-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
26NJ00877500 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
26NJ00877500 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750586582 | Susan P. Lake | Speech-Language Pathologist | 518 Meadow Mountain Dr., 518 Meadow Mountain Dr., Allenspark, CO 80510-0012 | 2007-06-20 |
| 1285687210 | Susan Lake | Optometrist | 601 E Russell Ave, Suite A, Warrensburg, MO 64093-9605 | 2006-05-19 |
| 1962784488 | Susan Lake | Psychologist | 4150 Clement St, 116b, San Francisco, CA 94121-1545 | 2011-09-10 |
| 1366679664 | Susan D Lake | Registered Nurse | 281 Sawyer Dr, Suite 100, Durango, CO 81303-3409 | 2009-06-15 |
| 1306003835 | Susan E Lake | Family Medicine | 4550 N Hamilton Rd, Gahanna, OH 43230-1714 | 2008-05-21 |
| Street Address |
1618 RIVERSIDE DRIVE |
| City | TRENTON |
| State | NJ |
| Zip Code | 08618 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104457993 | Capitals Pizzeria | Meals | 211 Reverend Howard S. Woodson Way, Trenton, NJ 08618 | 2020-01-30 |
| 1760049738 | Stem Civics, Inc. | Local Education Agency (LEA) | 1555 Pennington Road, Ewing, NJ 08618 | 2019-05-24 |
| 1497138705 | Jennifer Warren | Community Health Worker | 32 Newell Ave, Trenton, NJ 08618 | 2015-07-06 |
| 1447665500 | Avinique Marshall | Community Health Worker | 23 Van Duyn Dr, Ewing, NJ 08618 | 2014-06-27 |
| 1891116646 | Ameen Hasan Abdullah | Counselor | 132 Perry St., Trenton, NJ 08618 | 2013-12-20 |
| 1083042782 | Odelind King Lewis | Social Worker | 321 North Warren Street, Trenton, NJ 08618 | 2013-10-16 |
| 1346595089 | Essential Foot Care PC | Clinic/Center | 1440 Pennington Road, Ewing, NJ 08618 | 2012-07-18 |
| 1245543453 | Beverly M Gibson | Counselor | 68 Dunmore Avneue, Ewing, NJ 08618 | 2010-07-16 |
| 1386878353 | James C Wadley | Community/Behavioral Health | 312 Masterson Court, Ewing, NJ 08618 | 2009-05-06 |
| 1851537815 | Ilse K Thomas | Physician Assistant | 416 Bellevue Aveune, Suite 104, Trenton, NJ 08618 | 2008-12-22 |
| Find all providers in zip 08618 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871032557 | Theresa Mary Husby | Nurse Practitioner | 1640 Fort St Ste D, Trenton, MI 48183-2040 | 2017-02-15 |
| 1710511423 | Jacquelene Vertus | Nurse Practitioner | 750 Brunswick Ave, Trenton, NJ 08638-4143 | 2020-03-03 |
| 1770134660 | Rachel Hughes | Nurse Practitioner | 750 Brunswick Ave, Trenton, NJ 08638-4143 | 2019-09-23 |
| 1801458674 | Rachel H Adler | Nurse Practitioner | 750 Bruswick Ave, Trenton, NJ 08638 | 2019-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760098677 | Lauren Olmstead | Nurse Practitioner | 317 George St Ste 440, New Brunswick, NJ 08901-2008 | 2020-09-17 |
| 1275151961 | Natacha Jharahy | Nurse Practitioner | 2194 Stecher Ave, Union, NJ 07083-5252 | 2020-07-08 |
| 1477178424 | Dorota Mironiuk | Nurse Practitioner | 17 Reagan Way, Kinnelon, NJ 07405-2738 | 2020-06-15 |
| 1770111320 | Adrian A Sanchez | Nurse Practitioner | 28 Springbrook Rd E, Montville, NJ 07045-9162 | 2020-03-30 |
| 1356977409 | Gayle M Pistilli | Nurse Practitioner | 271 Cindy St, Old Bridge, NJ 08857-3060 | 2020-03-20 |
| 1578193876 | Melonie D Smith | Nurse Practitioner | 39 E 39th St Apt 4p, Paterson, NJ 07514-1163 | 2020-01-25 |
| 1710529151 | Anna M Comayagua | Nurse Practitioner | 82 Crab Apple Hill Rd, Milford, NJ 08848-1803 | 2019-10-16 |
| 1740830157 | Trisha Boland | Nurse Practitioner | 133 Center St Unit B2, New Milford, NJ 07646-2653 | 2019-09-17 |
| 1881242840 | Emily Lott | Nurse Practitioner | 1865 Rte 70 E, Cherry Hill, NJ 08003 | 2019-09-03 |
| 1528532397 | Jill Marie Generelli | Nurse Practitioner | 972 Hwy 36, Hazlet, NJ 07730-1700 | 2019-01-15 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.