Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LW0102X | Nurse Practitioner - Women's Health | 26NJ00130800 | NJ |
Y | 363LW0102X | Nurse Practitioner - Women's Health | SP009409 | PA |
NPI | 1063669802 |
---|---|
Provider Name | Ms. Lee-Ann Halbert |
First Address | Cherry Hill, NJ 08003-4407 |
Second Address | Cherry Hill, NJ 08003-4407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2008 |
Last Update Date | 22/08/2008 |