Individual
MRS. ELAINE MARIE THOMPSON-WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1725 BELL AVE, HAMILTON, NJ 08619-3022
(609) 273-7101
Mailing address
1725 BELL AVE, HAMILTON, NJ 08619-3022
(609) 273-7101
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
26NP05974700
NJ
Other
Enumeration date
08/06/2018
Last updated
08/06/2018
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