Healthcare Provider Details

I. General information

NPI: 1871563056
Provider Name (Legal Business Name): SUSAN JEANNE SCHNELL APN-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 10/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 ROUTE 33
NEPTUNE NJ
07753-4859
US

IV. Provider business mailing address

14 WEST ST
RUMSON NJ
07760-1614
US

V. Phone/Fax

Practice location:
  • Phone: 732-776-4196
  • Fax: 732-776-2488
Mailing address:
  • Phone: 732-741-3832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number26NJ00077100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberF430068-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: