NPI 1043618747

Alix Detullio, APN

Practitioner Acute Care Clinical Nurse Specialist Freehold, NJ

Practice location

Address: 901 W Main St, Freehold, NJ 07728-2537
Phone: (732) 431-0023
Mailing address: 4255 Route 9 N Suite B, Freehold, NJ 07728-8305

Registered specialties

Acute Care Clinical Nurse Specialist Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 364SA2100X Licence 26NJ00532200 (NJ)

Other Clinical Nurse Specialist providers in New Jersey →

Registry record

NPI: 1043618747
Entity type: Individual
Sex (as registered): Female
NPI issued: 11 Dec 2014
Record last updated: 11 Dec 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.