Tricia S Gravesande, NP
Nurse Practitioner, Gerontology in Orange, NJ. Individual provider (NPI-1).
NPI number1730719782
StatusActive
Last updated in NPPESJan 17, 2020
Details
- NPI
- 1730719782
- Entity type
- Individual (NPI-1)
- Name
- Miss Tricia S Gravesande
- Credential
- NP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 17, 2020
- Certification date
- Jan 17, 2020
- Last updated
- Jan 17, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LG0600X | Nurse Practitioner, Gerontology | 26NJ00959600 | NJ | Yes |
Practice location
133 Elm StOrange, NJ 07050-4001
Phone 862-224-0940
Mailing address
133 Elm StOrange, NJ 07050-4001
Phone 186-224-0940
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