Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 26NJ00894700 | NJ |
NPI | 1033673074 |
---|---|
Provider Name | Candace Atkins |
First Address | Sicklerville, NJ 08081-1911 |
Second Address | Sicklerville, NJ 08081-1911 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2019 |
Last Update Date | 23/01/2019 |