Provider Demographics
NPI:1346221629
Name:VIZZACHERO, NORA JEAN RHOADS (MSN, APN-C)
Entity Type:Individual
Prefix:MS
First Name:NORA
Middle Name:JEAN RHOADS
Last Name:VIZZACHERO
Suffix:
Gender:F
Credentials:MSN, APN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FEDERAL ST # 200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1088
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:
Practice Address - Street 1:3 COOPER PLZ RM 200
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1438
Practice Address - Country:US
Practice Address - Phone:856-342-2001
Practice Address - Fax:856-968-8206
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN09353900363LP0200X
NJ26NJ00275400363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJS58844Medicare UPIN
NJ011688Medicare ID - Type Unspecified