Individual
ELLEN T VAN FOSSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, APN
Contact information
Practice address
42 LAUREL RD E, UDP #1800, STRATFORD, NJ 08084-1354
(856) 566-6843
(856) 566-6419
Mailing address
42 E LAUREL RD, UDP #1800, STRATFORD, NJ 08084-1354
(856) 566-6843
(856) 566-6419
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
NO08244100
NJ
363LG0600X
Gerontology Nurse Practitioner
Primary
NN08244100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8132208
—
NJ
Enumeration date
01/19/2006
Last updated
01/06/2016
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