Individual
MARISSA GUNDERSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RN.,APN C
Contact information
Practice address
572 COOKMAN AVE, ASBURY PARK, NJ 07712-7102
(732) 774-6333
(732) 774-8083
Mailing address
500 WOODMERE AVE, NEPTUNE, NJ 07753-5636
Taxonomy
Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
Primary
26NJ00021000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
X5/19
—
NJ
Enumeration date
05/19/2006
Last updated
07/21/2022
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