Provider Demographics
NPI:1659542314
Name:YECCO, GISELLE J (ANP-C)
Entity Type:Individual
Prefix:
First Name:GISELLE
Middle Name:J
Last Name:YECCO
Suffix:
Gender:F
Credentials:ANP-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
Mailing Address - Street 2:STE SW200
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1155
Mailing Address - Country:US
Mailing Address - Phone:856-963-6888
Mailing Address - Fax:856-342-8007
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:7TH FLOOR
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-342-2265
Practice Address - Fax:856-342-8007
Is Sole Proprietor?:No
Enumeration Date:2008-03-20
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNO8229100363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJNN08229100OtherSTATE LICENSE