Individual
LORRAINE M ANTICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN C
Contact information
Practice address
ONE COOPER PLAZA, COOPER UNIVERSITY TRAUMA PHYSICIANS, CAMDEN, NJ 08103
(856) 342-3014
Mailing address
1 FEDERAL ST # 200, CAMDEN, NJ 08103-1088
(856) 356-4924
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NN05816800
NJ
363L00000X
Nurse Practitioner
SP001886C
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NN05816800
STATE
NJ
Enumeration date
10/02/2006
Last updated
10/18/2019
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