Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | 26NJ00631900 | NJ |
Y | 363LG0600X | Nurse Practitioner - Gerontology | 26NJ00631900 | NJ |
N | 363LP2300X | Nurse Practitioner - Primary Care | 26NJ00631900 | NJ |
NPI | 1003260068 |
---|---|
Provider Name | Danielle Healy |
First Address | Ledgewood, NJ 07852-2601 |
Second Address | Ledgewood, NJ 07852-2601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2016 |
Last Update Date | 15/04/2016 |