Provider Demographics
NPI:1467024430
Name:SECHE, FAVIOLA (NP)
Entity Type:Individual
Prefix:MRS
First Name:FAVIOLA
Middle Name:
Last Name:SECHE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-2737
Mailing Address - Country:US
Mailing Address - Phone:609-386-0775
Mailing Address - Fax:
Practice Address - Street 1:651 HIGH ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON CITY
Practice Address - State:NJ
Practice Address - Zip Code:08016-2737
Practice Address - Country:US
Practice Address - Phone:609-386-0775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-10
Last Update Date:2021-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01134000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty