Provider Demographics
NPI:1730161837
Name:GILZEAN, SUSAN (NP)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:GILZEAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CMR 427 BOX 625
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09630
Mailing Address - Country:IT
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:UNIT 31403 BOX 13
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09630
Practice Address - Country:IT
Practice Address - Phone:00139044-471-6602
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA336573; NP CERT 3812363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health