MEDICARE: MARY K DRENNEN 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
1	363LF0000X	Family Nurse Practitioner	26NN05109500	NJ
2	363L00000X	Nurse Practitioner	26NN05109500	NJ

General Provider Information

NPI Number	:	1538103437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY K DRENNEN APN

Provider Business Mailing Address
First Line	:	2106 NEW RD STE F1
Second Line	:
City	:	LINWOOD
State	:	NJ
Zip	:	08221-1053
Country	:	US
Telephone Number	:	609-699-5750
Fax Number	:	609-699-5752

Provider Business Practice Location Address
First Line	:	1418 NEW RD STE 1C
Second Line	:
City	:	NORTHFIELD
State	:	NJ
Zip	:	08225-1179
Country	:	US
Telephone Number	:	609-699-5750
Fax Number	:	609-699-5752

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

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	02/26/2026

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