Provider Demographics
NPI:1710258918
Name:MCGONIGLE, ROSEMARY BRENNAN (APN)
Entity Type:Individual
Prefix:MRS
First Name:ROSEMARY
Middle Name:BRENNAN
Last Name:MCGONIGLE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 RACCOON CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-9681
Mailing Address - Country:US
Mailing Address - Phone:856-223-0376
Mailing Address - Fax:
Practice Address - Street 1:4 RACCOON CREEK RD
Practice Address - Street 2:
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062-9681
Practice Address - Country:US
Practice Address - Phone:856-223-0376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-19
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR07189100163W00000X
PARN288228L163W00000X
NJ26NJ00713900363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse