Individual
MS. MIRLINE CHAMPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5 MANOR DR, APT 15H, NEWARK, NJ 07106-3276
(862) 234-6472
Mailing address
5 MANOR DR, APT 15H, NEWARK, NJ 07106-3276
(862) 234-6472
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
289470
NY
Other
Enumeration date
04/09/2010
Last updated
04/09/2010
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