Provider Demographics
NPI:1568694974
Name:KONZEL, CARA MIA (MS, RN, ACNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:CARA
Middle Name:MIA
Last Name:KONZEL
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Gender:F
Credentials:MS, RN, ACNP-BC
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Mailing Address - Street 1:721 CLIFTON AVE
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-1880
Mailing Address - Country:US
Mailing Address - Phone:973-777-7727
Mailing Address - Fax:973-779-7906
Practice Address - Street 1:721 CLIFTON AVE
Practice Address - Street 2:SUITE 2A
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-1880
Practice Address - Country:US
Practice Address - Phone:973-777-7727
Practice Address - Fax:973-779-7906
Is Sole Proprietor?:No
Enumeration Date:2009-08-18
Last Update Date:2014-01-16
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00212100363LA2100X
NYF430401363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care