Individual
DESTINY MICHELE DIBONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
151 FRIES MILL RD STE 301, TURNERSVILLE, NJ 08012-2016
(856) 374-1881
Mailing address
151 FRIES MILL RD STE 301, TURNERSVILLE, NJ 08012-2016
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
26NJ00933100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0712582
—
NJ
Enumeration date
10/16/2019
Last updated
02/06/2020
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