Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 26NJ00571200 | NJ |
NPI | 1013385103 |
---|---|
Provider Name | Elizabeth Mcgourty |
First Address | Flemington, NJ 08822-4953 |
Second Address | Flemington, NJ 08822-4953 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2015 |
Last Update Date | 27/08/2020 |