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General NPI Number Information
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NPI Number | 1023762374
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Entity Type | Individual
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Provider Name | KATHLEEN NORA GAZZO RN, APN
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Gender | Female
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Dates
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Enumeration Date | 02/07/2022
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 390 AMWELL RD STE 106
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City | HILLSBOROUGH
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State | NJ
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Zip | 08844-1226
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Country | US
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Telephone | 908-431-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 401 ROUTE 73 N STE 320
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City | MARLTON
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State | NJ
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Zip | 08053-3426
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Country | US
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Telephone | 908-431-3100
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 26NJ01390000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number | 26NO11778200
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License Number State | NJ
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