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General NPI Number Information
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NPI Number | 1083628887
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Entity Type | Individual
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Provider Name | VALERIE VINCEK CRNA
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Gender | Female
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 435 HURFFVILLE - CROSS KEYS RD KENNEDY HEALTH SYSTEM
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City | SEWELL
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State | NJ
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Zip | 08080
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Country | US
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Telephone | 856-582-1419
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Fax |
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Provider Business Mailing Address
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Address Line | 700 US 130 N SUITE 203
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City | CINNAMINSON
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State | NJ
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Zip | 08077
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Country | US
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Telephone | 856-829-9345
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Fax | 856-829-0580
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 26NO05899300
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License Number State | NJ
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