Individual
MRS. ANDREA MARIE LICCINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
217 ARDMORE AVE, HADDONFIELD, NJ 08033
(856) 912-5191
Mailing address
217 ARDMORE AVE, HADDONFIELD, NJ 08033
(856) 912-5191
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
26NR12896700
NJ
Other
Enumeration date
02/17/2009
Last updated
02/18/2015
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