Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 26NJ00848700 | NJ |
N | 363LP0200X | Nurse Practitioner - Pediatrics | SP015941 | PA |
NPI | 1174971444 |
---|---|
Provider Name | Mrs. Nicole Joyce Schenk |
First Address | Camden, NJ 08103-1088 |
Second Address | Camden, NJ 08103-1461 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2016 |
Last Update Date | 19/04/2021 |