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NPI Code Detail

MEDICARE: MRS. MICHELLE REMY PHILLIPS-COTTRELL APN

MEDICARE: MRS. MICHELLE REMY PHILLIPS-COTTRELL APN
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
1363LF0000XFamily Nurse Practitioner26NJ00457700NJ

General Provider Information

NPI Number : 1376979724
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MICHELLE REMY PHILLIPS-COTTRELL APN
Provider Business Mailing Address
First Line : 53 S LAUREL ST
Second Line :
City : BRIDGETON
State : NJ
Zip : 08302-1946
Country : US
Telephone Number : 856-451-4700
Fax Number : 856-794-7183
Provider Business Practice Location Address
First Line : 3700 NEW JERSEY AVE
Second Line :
City : WILDWOOD
State : NJ
Zip : 08260-6154
Country : US
Telephone Number : 609-465-0258
Fax Number : 609-522-3484
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2013
Last Update Date : 01/29/2014

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