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General NPI Number Information
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NPI Number | 1780188706
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Entity Type | Organization
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Legal Business Name | CLEAR HORIZONS HEALTHCARE
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Dates
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Enumeration Date | 03/23/2018
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Last Update Date | 03/23/2018
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Provider Practice Location Address
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Address Line | 220 S WHITE HORSE PIKE FL 2
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City | AUDUBON
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State | NJ
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Zip | 08106-1371
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Country | US
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Telephone | 856-433-1808
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Fax | 856-433-1809
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Provider Business Mailing Address
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Address Line | 1017 ABINGTON RD
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City | CHERRY HILL
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State | NJ
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Zip | 08034-3903
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Country | US
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Telephone | 856-266-8033
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Fax | 856-433-1809
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Authorized Official
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Title or Position | OWNER
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Name | HERMINA WATERS
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Credential | APN
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Telephone | 856-433-1808
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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 | 26NJ00301600
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License Number State | NJ
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