| NPI | 1023358561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY LYNN DONNELL-JACKSON Nurse Practitioner/Director 856-889-9577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2013-02-20 |
| Last Update Date | 2013-02-20 |