SearchNew Jersey363LP0200X

Amy Provenzano, CPNP-PC

NPI 1487178687 · on the registry since 2017

Practice

Address
67a Mountain Boulevard Ext
1st Floor, Unit B
Warren, NJ 07059
Phone
(858) 216-8837
Clinicians at this address
16

Registry record

Primary taxonomy
363LP0200X
363LP0200X
Also registered as
363LP0200X
363LP0200X
Licence states on file
OH, NJ, CA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2023-02-02

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New Jersey