Provider Demographics
NPI:1790351872
Name:DSOUZA, PRECY LAVINA (RN,PCCN,MSN)
Entity Type:Individual
Prefix:MRS
First Name:PRECY
Middle Name:LAVINA
Last Name:DSOUZA
Suffix:
Gender:F
Credentials:RN,PCCN,MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1197 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:HADDON TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-3333
Mailing Address - Country:US
Mailing Address - Phone:267-394-2044
Mailing Address - Fax:
Practice Address - Street 1:100 BOWMAN DR
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-1596
Practice Address - Country:US
Practice Address - Phone:856-247-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-31
Last Update Date:2021-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR11851300163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care