Individual
KATHY ELLARENE NOVELLA PROCTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, BSN, RN- CCM
Contact information
Practice address
182 E LINDEN AVE, DUMONT, NJ 07628-1916
(646) 401-3115
(201) 330-4645
Mailing address
182 E LINDEN AVE, DUMONT, NJ 07628-1916
(646) 401-3115
(201) 330-4645
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
—
—
163WC0400X
Case Management Registered Nurse
Primary
26NR22095100
NJ
163WC0400X
Case Management Registered Nurse
543566
NY
171M00000X
Case Manager/Care Coordinator
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/22/2022
Last updated
03/27/2026
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