Individual
MARY A HERRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
70 COHANSEY ST, BRIDGETON, NJ 08302
(856) 451-4700
(856) 451-0029
Mailing address
5511 PACIFIC AVE, C-204, WILDWOOD, NJ 08260-4360
(609) 522-1555
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
NN03109700
NJ
363LW0102X
Women's Health Nurse Practitioner
Primary
26NN03109700
NJ
Other
Enumeration date
06/28/2006
Last updated
06/21/2018
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