Individual
KELLY T OCAMPO VIVAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
195 LITTLE ALBANY ST, NEW BRUNSWICK, NJ 08901-1914
(732) 235-2465
Mailing address
195 LITTLE ALBANY ST, NEW BRUNSWICK, NJ 08901-1914
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NJ14939900
NJ
Other
Enumeration date
10/19/2023
Last updated
10/19/2023
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