MEDICARE: MRS. CAROL ELLEN MEST RN, APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	364S00000X	Clinical Nurse Specialist	26NC06493600	NJ

General Provider Information

NPI Number	:	1336346493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAROL ELLEN MEST RN, APN

Provider Business Mailing Address
First Line	:	1113 HOSPITAL DR
Second Line	:	SUITE 100
City	:	WILLINGBORO
State	:	NJ
Zip	:	08046-1103
Country	:	US
Telephone Number	:	609-835-5240
Fax Number	:	609-835-5241

Provider Business Practice Location Address
First Line	:	1113 HOSPITAL DR
Second Line	:	SUITE 100
City	:	WILLINGBORO
State	:	NJ
Zip	:	08046-1103
Country	:	US
Telephone Number	:	609-835-5240
Fax Number	:	609-835-5241

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2007
Last Update Date	:	05/14/2012

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