Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP2300X | Nurse Practitioner - Primary Care | 004669 | CT |
Y | 363LP2300X | Nurse Practitioner - Primary Care | 26NJ00337400 | NJ |
NPI | 1073890562 |
---|---|
Provider Name | Ms. Joan Andersen Twombly |
First Address | Baltimore, MD 21228-4873 |
Second Address | Pompton Plains, NJ 07444 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2011 |
Last Update Date | 17/12/2018 |