Healthcare Provider Details

I. General information

NPI: 1518052596
Provider Name (Legal Business Name): HOPE R MCKEE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HOPE WIENER

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 09/01/2022
Certification Date: 09/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2309 E EVESHAM RD STE 201A
VOORHEES NJ
08043-1559
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 856-325-5400
  • Fax: 856-325-5416
Mailing address:
  • Phone: 856-355-0340
  • Fax: 856-355-0330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberTP004013P
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number26NJ00344000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: