Individual
NICOLE PIVONKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
158 ROUTE 73 STE B, VOORHEES, NJ 08043-9539
(856) 247-7230
(856) 247-7231
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 355-0340
(856) 355-0330
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
26NR18617100
NJ
363L00000X
Nurse Practitioner
Primary
26NJ00986300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0726702
—
NJ
Enumeration date
07/19/2019
Last updated
01/07/2025
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