Individual
SUSAN STIVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
92 2ND ST, HACKENSACK, NJ 07601-2191
(551) 996-3033
Mailing address
52 ROSE LN, ROCKAWAY, NJ 07866-3324
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NN05694300
NJ
Other
Enumeration date
05/30/2018
Last updated
05/30/2018
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