NPI | 1376107839 |
---|---|
Former Name | NICOLE MARIE KORDZIEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00927200) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR18161900) |
Enumeration Date | 2019-04-30 |
Last Update Date | 2023-05-24 |