Individual
MRS. KISHA TAMARA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
151 WASHINGTON ST, NEWARK, NJ 07102-3026
(973) 622-3900
(973) 622-1698
Mailing address
312 STUYVESANT AVE, NEWARK, NJ 07106-3637
(973) 399-5265
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
26NN11131200
NJ
Other
Enumeration date
02/22/2006
Last updated
07/13/2011
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