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General NPI Number Information
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NPI Number | 1588130595
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Entity Type | Individual
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Provider Name | MALLORY HONEYWELL
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Gender | Female
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Dates
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Enumeration Date | 10/17/2018
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 158 ROUTE 73 STE B
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City | VOORHEES
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State | NJ
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Zip | 08043-9539
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Country | US
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Telephone | 856-247-7230
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Fax | 856-247-7231
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Provider Business Mailing Address
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Address Line | 42 AMBERFIELD DR
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City | DELRAN
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State | NJ
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Zip | 08075-2833
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Country | US
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Telephone | 609-828-5425
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ00852800
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License Number State | NJ
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