Individual
KELLY TAXERAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
92 2ND ST, HACKENSACK, NJ 07601-2191
(551) 996-5900
Mailing address
31 BRANDYWINE PL, OAKLAND, NJ 07436-2313
(201) 669-0792
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ01194000
NJ
Other
Enumeration date
09/03/2021
Last updated
02/02/2023
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