| Doctor Name: | MARISSA GUNDERSON |
| NPI Number: | 1639122682 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN.,APN C |
| License Number: | 26NJ00021000 |
| Business Practice Address: | 572 Cookman Ave Asbury Park, NJ - 077127102 |
| Business Phone Number: | 7327746333 |
| Business Fax Number: | 7327748083 |
| Mailing Address: | 500 Woodmere Ave, NEPTUNE |
| State: | NJ |
| Postal Code: | 077535636 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/19/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LC1500X |
| License Number: | 26NJ00021000 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |