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Individual

LISA M EWAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
875 KINGS HWY STE 100, WEST DEPTFORD, NJ 08096-3165
(856) 251-0500
Mailing address
6 N BROAD ST, SUITE 301, WOODBURY, NJ 08096-4635
(856) 251-0500

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
26NJ00365500
NJ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ00365500
NJ

Other

Enumeration date
02/03/2012
Last updated
08/11/2023
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