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General NPI Number Information
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NPI Number | 1073320008
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Entity Type | Individual
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Provider Name | DE-ANDRA DANEISHA WARBERTON NP
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Gender | Female
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Dates
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Enumeration Date | 12/13/2024
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 277 ROUTE 70
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City | TOMS RIVER
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State | NJ
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Zip | 08755-1569
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Country | US
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Telephone | 212-516-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 277 ROUTE 70
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City | TOMS RIVER
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State | NJ
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Zip | 08755-1569
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Country | US
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Telephone | 212-516-2300
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 311882
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License Number State | NY
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