Healthcare Provider Details

I. General information

NPI: 1730161837
Provider Name (Legal Business Name): SUSAN GILZEAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIT 31403 BOX 13
APO AE
09630
IT

IV. Provider business mailing address

CMR 427 BOX 625
APO AE
09630
IT

V. Phone/Fax

Practice location:
  • Phone: 001390444716602
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number336573; NP CERT 3812
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: