| Doctor Name: | LISA JOY FETCHKO |
| NPI Number: | 1356706964 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSN.ED, RN |
| License Number: | 26NR11111900 |
| Business Practice Address: | 23 Primrose Pl Delran, NJ - 080752818 |
| Business Phone Number: | 6097815627 |
| Business Fax Number: | 8564618138 |
| Mailing Address: | 23 Primrose Pl, DELRAN |
| State: | NJ |
| Postal Code: | 080752818 |
| Phone Number: | 6097815627 |
| Fax Number: | 8564618138 |
| NPI Enumeration Date: | 12/24/2015 |
| NPI Last Update Date: | 12/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC0400X |
| License Number: | 26NR11111900 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Case Management |
| Taxonomy Definition: | |