Doctor Name: | BRENDA L ALLGOOD |
NPI Number: | 1073706222 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN, CPNP |
License Number: | 26NJ00115600 |
Business Practice Address: | 1050 Mantua Pike 601 Office Plaza, 2nd Floor Wenonah, NJ - 080901141 |
Business Phone Number: | 8564688330 |
Business Fax Number: | 8564689121 |
Mailing Address: | 1050 Mantua Pike, 601 Office Plaza, 2nd Floor WENONAH |
State: | NJ |
Postal Code: | 080901141 |
Phone Number: | 8564688330 |
Fax Number: | 8564689121 |
NPI Enumeration Date: | 08/21/2007 |
NPI Last Update Date: | 08/21/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | 26NJ00115600 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |