Individual
MS. KRISTEN ENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
30 PROSPECT AVE, HACKENSACK, NJ 07601-1915
(551) 996-4078
(551) 996-4140
Mailing address
51 WOODCREST DR, WOODCLIFF LAKE, NJ 07677-7629
(845) 304-4459
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ00453200
NJ
363LG0600X
Gerontology Nurse Practitioner
26NJ00453200
NJ
Other
Enumeration date
08/06/2013
Last updated
04/11/2024
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