Individual
THERESA GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
GNP-BC, MSN, CWOCN
Contact information
Practice address
1600 HADDON AVE, CAMDEN, NJ 08103-3101
(856) 968-2573
Mailing address
1600 HADDON AVE, CAMDEN, NJ 08103-3101
(856) 968-2573
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
26NN05973500
NJ
363LG0600X
Gerontology Nurse Practitioner
Primary
26NN05973500
NJ
Other
Enumeration date
08/06/2009
Last updated
08/06/2009
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