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Individual

DEBORAH LEE KLANCHAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3 COOPER PLZ RM 411, CAMDEN, NJ 08103-1438
(856) 342-3250
Mailing address
1 FEDERAL ST STE SW200, CAMDEN, NJ 08103-1155
(856) 356-4924

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
26NJ00765100
NJ
363LP2300X
Primary Care Nurse Practitioner
26NR13517200
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
26NR13517200
STAT OF NEW JERSEY OFFICE OF ATTORNEY GENERAL DIVISION OF CONSUMER AFFAIRS
NJ
01
RN609518
COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE
PA
Enumeration date
09/11/2017
Last updated
05/06/2019
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