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Individual

MAE LYNNE TIETJE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, RN, APN, AGNP-C

Contact information

Practice address
3830 ATLANTIC AVE, ATLANTIC CITY, NJ 08401-6080
(609) 345-6000
Mailing address
274 DEERFIELD DR, MAYS LANDING, NJ 08330-4924
(609) 204-6792

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
26NJ01069800
NJ

Other

Enumeration date
11/07/2020
Last updated
11/07/2020
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