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Individual
MRS. LAURA MAE VAN FOSSEN
Active
Individual
MRS. LAURA MAE VAN FOSSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CNM
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26RN16127800
NJ
367A00000X
Advanced Practice Midwife
25ME00085100
NJ
367A00000X
Advanced Practice Midwife
Primary
25ME00085101
NJ
Other
Enumeration date
12/07/2023
Last updated
12/29/2023
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