Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Perinatal |
363LP1700X | 50 | Nurse Practitioner |
| NPI Number | 1376748103 |
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| LBN Legal business name | UMDNJ RWJ OBGYN | ||||
| Authorized official | CHRISTINE JACKSON - (PROGRAM ASSISTANT) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 06/20/2007 | ||||
| Last updated | 08/22/2020 - About 6 years ago | ||||
| Identifiers |
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