Individual
LAURIE JANSSON DIDYK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN APN
Contact information
Practice address
1361 ROUTE 72 W, MANAHAWKIN, NJ 08050-2417
(609) 978-0600
(609) 978-1635
Mailing address
1361 ROUTE 72 W, MANAHAWKIN, NJ 08050-2417
(609) 978-0600
(609) 978-1635
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NO06959300
NJ
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ00054900
NJ
363LF0000X
Family Nurse Practitioner
26NJ00054900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0038491
—
NJ
Enumeration date
02/18/2006
Last updated
04/06/2012
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