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NPI Code Detail

MEDICARE: MISS SUSAN J HOLTON CRNP

MEDICARE: MISS SUSAN J HOLTON CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN303136LPA
2163WC2100XContinence Care Registered NurseRN303136LPA
3163WE0900XEnterostomal Therapy Registered NurseRN303136LPA
4163WR0400XRehabilitation Registered NurseRN303136LPA
5163WW0000XWound Care Registered NurseRN303136LPA
6363LG0600XGerontology Nurse PractitionerTP003487HPA

General Provider Information

NPI Number : 1528071552
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS SUSAN J HOLTON CRNP
Provider Business Mailing Address
First Line : 32 W EVERGREEN AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19118-3315
Country : US
Telephone Number : 215-248-0243
Fax Number :
Provider Business Practice Location Address
First Line : 3900 WOODLAND AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-4551
Country : US
Telephone Number : 215-823-4615
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2006
Last Update Date : 09/11/2025

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Directions to “ MISS SUSAN J HOLTON CRNP” Practice Location

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