Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | NN92499 | NJ |
N | 363LN0000X | Nurse Practitioner - Neonatal | NR92499 | NJ |
NPI | 1164512042 |
---|---|
Provider Name | Pam M Gutman |
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 | 13/10/2006 |
Last Update Date | 20/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0082767 | (05) | NJ |
010005547 | AMERICHOICE (01) | NJ |
2566419 | UNITED HEALTHCARE (01) | NJ |
3K6367 | HEALTHNET (01) | NJ |
42285 | UNIVERSITY HEALTH PLAN (01) | NJ |
60027019 | HORIZON NJ HEALTH (01) | NJ |