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General NPI Number Information
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NPI Number | 1225243124
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Entity Type | Individual
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Provider Name | KRISTINA MARIE LUNDQUIST N.P.
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Gender | Female
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 305 OLDHAM RD PREAKNESS HEALTH CARE
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City | WAYNE
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State | NJ
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Zip | 07470-2208
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Country | US
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Telephone | 973-904-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 18 PHILLIPS RD
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City | HEWITT
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State | NJ
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Zip | 07421-3223
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Country | US
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Telephone | 973-657-0675
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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 | NN71040
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License Number State | NJ
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