Individual
MRS. PHYLLIS MCKIERNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, APN-C
Contact information
Practice address
20 PROSPECT AVE STE 400, HACKENSACK, NJ 07601-1941
(201) 996-5832
Mailing address
14 MANNING RD, PARAMUS, NJ 07652-1800
(201) 251-6474
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ00034600
NJ
Other
Enumeration date
05/10/2007
Last updated
07/08/2007
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