Individual
KIM ELLEN ROYCROFT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
200 TRENTON RD, BROWNS MILLS, NJ 08015-1705
(609) 893-1200
Mailing address
200 TRENTON RD, BROWNS MILLS, NJ 08015-1705
(609) 893-1200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C5-0011654
DE
363AM0700X
Medical Physician Assistant
Primary
25MP00256100
NJ
Other
Enumeration date
10/04/2011
Last updated
12/21/2021
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