Individual
MS. MARCY K. DEEMEDIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
L1-0028892
DE
363L00000X
Nurse Practitioner
LJ0000225
DE
363LP0200X
Pediatric Nurse Practitioner
LJ0000225
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0056014
—
NJ
05
—
4067525
—
MD
Enumeration date
09/28/2006
Last updated
11/22/2021
Update your record
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