Healthcare Provider Details

I. General information

NPI: 1053409730
Provider Name (Legal Business Name): DOLORES TURSE ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

238 E BROADWAY
SALEM NJ
08079-1108
US

IV. Provider business mailing address

860 S WHITE HORSE PIKE
HAMMONTON NJ
08037-2018
US

V. Phone/Fax

Practice location:
  • Phone: 856-935-7711
  • Fax: 856-935-9123
Mailing address:
  • Phone: 609-567-0200
  • Fax: 609-704-1482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NN05278600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: