Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 26NJ01077000 | NJ |
N | 363LW0102X | Nurse Practitioner - Women's Health | SP022616 | PA |
NPI | 1073114500 |
---|---|
Provider Name | Lynnsey Nicole Null |
First Address | Marlton, NJ 08053 |
Second Address | Moorestown, NJ 08057-4800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2020 |
Last Update Date | 01/02/2021 |