Provider Demographics
NPI:1801415112
Name:DRISCOLL, HILLARY JO (APN)
Entity Type:Individual
Prefix:
First Name:HILLARY JO
Middle Name:
Last Name:DRISCOLL
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 1:201 LAUREL OAK RD STE B
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4424
Mailing Address - Country:US
Mailing Address - Phone:856-566-5478
Mailing Address - Fax:856-566-9561
Practice Address - Street 1:201 LAUREL OAK RD STE B
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4424
Practice Address - Country:US
Practice Address - Phone:856-566-5478
Practice Address - Fax:856-566-9561
Is Sole Proprietor?:No
Enumeration Date:2020-04-16
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01015700363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health