Healthcare Provider Details

I. General information

NPI: 1073323861
Provider Name (Legal Business Name): AMY VESTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2025
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 NEW RD STE 201
LINWOOD NJ
08221-1281
US

IV. Provider business mailing address

PO BOX 15825
BELFAST ME
04915-4053
US

V. Phone/Fax

Practice location:
  • Phone: 609-788-8953
  • Fax: 609-904-6929
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NR20321500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: