Individual
MS. KELLY NUSSBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
163 ENGLE ST STE 4A, ENGLEWOOD, NJ 07631-2530
(201) 408-4487
(800) 352-3015
Mailing address
9 RICKER RD, KINNELON, NJ 07405
(973) 838-8869
Taxonomy
Speciality
Code
Description
License number
State
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
26NC07471600
NJ
Other
Enumeration date
05/05/2011
Last updated
05/05/2011
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