Individual
BROOKE L WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3592 N DELSEA DR UNIT 16, VINELAND, NJ 08360-1657
(856) 558-1677
Mailing address
3592 N DELSEA DR UNIT 16, VINELAND, NJ 08360-1657
(856) 213-6836
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
26NR19109300
NJ
Other
Enumeration date
01/20/2021
Last updated
01/20/2021
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