Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 26NN07753700 | NJ |
N | 363LX0001X | Nurse Practitioner - Obstetrics & Gynecology | 26NN07753700 | NJ |
NPI | 1053526830 |
---|---|
Provider Name | Meryl Penalver |
First Address | Marlton, NJ 08053-4197 |
Second Address | Voorhees, NJ 08043-9636 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 19/01/2021 |