Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 26NJ00995700 | NJ |
NPI | 1134768419 |
---|---|
Provider Name | Kelli L Gramlich |
First Address | Atlantic City, NJ 08401-6713 |
Second Address | Atlantic City, NJ 08401-6713 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2020 |
Last Update Date | 02/09/2021 |