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NPI 1023489093

NPI 1023489093 : ERIN KISSEL A.P.N. : NEWARK, NJ

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General NPI Number Information
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    NPI Number           |    1023489093
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    Entity Type          |    Individual 
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    Provider Name        |    ERIN KISSEL A.P.N.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/15/2015
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    Last Update Date     |    01/20/2020
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Provider Practice Location Address
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    Address Line         |    201 LYONS AVE 4L
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    City                 |    NEWARK
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    State                |    NJ
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    Zip                  |    07112-2027
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    Country              |    US
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    Telephone            |    973-926-7205
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    201 LYONS AVE 4L
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    City                 |    NEWARK
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    State                |    NJ
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    Zip                  |    07112-2027
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    Country              |    US
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    Telephone            |    973-926-7205
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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        |    363L00000X
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    Taxonomy Name        |    Nurse Practitioner
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    License Number       |    631289
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    License Number State |    NY
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