Individual
REBECA RAQUEL IZTUETA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
19 GALLAGHER LN, WHARTON, NJ 07885-1907
(973) 874-6107
Mailing address
19 GALLAGHER LN, WHARTON, NJ 07885-1907
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2019075991
NJ
Other
Enumeration date
01/22/2020
Last updated
01/22/2020
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