Individual
NODEEN GLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
208 BLOOMFIELD AVE APT 112, BLOOMFIELD, NJ 07003-5795
(973) 878-2343
Mailing address
208 BLOOMFIELD AVE APT 112, BLOOMFIELD, NJ 07003-5795
(973) 878-2343
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
26NR15243600
NJ
Other
Enumeration date
09/10/2019
Last updated
09/10/2019
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