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Individual

LAURIE MOODY-TIDCOMBE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
2500 ENGLISH CREEK AVE, SUITE 222, EGG HARBOR TOWNSHIP, NJ 08234-5549
(609) 407-2365
(609) 407-2364
Mailing address
2500 ENGLISH CREEK AVE, SUITE 222, EGG HARBOR TOWNSHIP, NJ 08234-5549
(609) 407-2365
(609) 407-2364

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NJ00143100
NJ

Other

Enumeration date
09/24/2007
Last updated
03/03/2008
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