NPI | 1730545567 |
---|---|
Entity Type | Organization |
Authorized Contact | TANYA MONIQUE BRONZELL-WYNDER CEO 856-288-9115 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00600900) |
Additional Taxonomies | 261Q00000X Clinic/Center (Licence: PA SP008348) |
363LC1500X Nurse Practitioner, Community Health (Licence: PA SP013200) | |
Enumeration Date | 2016-01-09 |
Last Update Date | 2023-10-02 |