Individual
ROSANNE NIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
213 2ND AVE, TUCKERTON, NJ 08087-2733
(800) 950-6066
Mailing address
213 2ND AVE, TUCKERTON, NJ 08087-2733
(800) 950-6066
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
26NP03463400
NJ
Other
Enumeration date
10/12/2009
Last updated
10/12/2009
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