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Individual
LISA MARIE VEENEMA
Active
Individual
LISA MARIE VEENEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00248600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MP00248600
NJ LICENSE
NJ
Enumeration date
05/23/2011
Last updated
04/15/2014
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