MEDICARE: HELENE E FEDELE ACNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	26NN06491300	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053367037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HELENE E FEDELE ACNP

Provider Business Mailing Address
First Line	:	406 E GIBBSBORO RD
Second Line	:
City	:	LINDENWOLD
State	:	NJ
Zip	:	08021-1907
Country	:	US
Telephone Number	:	609-437-2020
Fax Number	:	609-345-4290

Provider Business Practice Location Address
First Line	:	2922 ATLANTIC AVE
Second Line	:	2ND FLOOR
City	:	ATLANTIC CITY
State	:	NJ
Zip	:	08401-6337
Country	:	US
Telephone Number	:	609-437-2020
Fax Number	:	609-345-4290

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	12/14/2018

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Directions to “ HELENE E FEDELE ACNP” Practice Location

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