Healthcare Provider Details

I. General information

NPI: 1548356868
Provider Name (Legal Business Name): NANCY ELLEN EISENBERGER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 05/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 E. EVESHAM ROAD BLDG 800, SUITE 115
VOORHEES NJ
08043
US

IV. Provider business mailing address

2301 E. EVESHAM ROAD BLDG 800, SUITE 115
VOORHEES NJ
08043-4509
US

V. Phone/Fax

Practice location:
  • Phone: 856-424-5005
  • Fax: 856-424-4716
Mailing address:
  • Phone: 856-424-5005
  • Fax: 856-424-4716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ00687400
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00687400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: