Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 26NJ00216200 | NJ |
NPI | 1003149477 |
---|---|
Provider Name | Ms. Ashley Storms |
First Address | Warwick, NY 10990-1035 |
Second Address | Mahwah, NJ 07430-1304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2009 |
Last Update Date | 26/10/2018 |