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General NPI Number Information
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NPI Number | 1003687591
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Entity Type | Individual
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Provider Name | CHEVON ALEASE NEAL-MINK FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/12/2024
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Last Update Date | 01/30/2024
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Provider Practice Location Address
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Address Line | 500 BERLIN CROSS KEYS RD
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City | SICKLERVILLE
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State | NJ
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Zip | 08081-4355
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Country | US
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Telephone | 856-536-1536
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Fax |
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Provider Business Mailing Address
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Address Line | 1 FEDERAL ST STE 200
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City | CAMDEN
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State | NJ
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Zip | 08103-1088
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Country | US
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Telephone | 848-288-6935
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ14942400
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License Number State | NJ
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