Healthcare Provider Details

I. General information

NPI: 1669594602
Provider Name (Legal Business Name): KERRI P PENDERS DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 09/05/2023
Certification Date: 09/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 WHITEHORSE-MERCERVILLE ROAD SUITE 219
HAMILTON NJ
08619-3834
US

IV. Provider business mailing address

1401 WHITEHORSE MERCERVILLE RD STE 219
HAMILTON NJ
08619-3835
US

V. Phone/Fax

Practice location:
  • Phone: 609-584-5150
  • Fax: 609-584-5144
Mailing address:
  • Phone: 609-584-5150
  • Fax: 609-584-5144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ00067900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: