Provider Demographics
NPI:1891545364
Name:LINNEMAN, NICOLE LYNN (RN, BSN)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:LYNN
Last Name:LINNEMAN
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:LYNN
Other - Last Name:LIQUORI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:516 ARLINE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:NJ
Mailing Address - Zip Code:08029-1004
Mailing Address - Country:US
Mailing Address - Phone:856-981-3289
Mailing Address - Fax:
Practice Address - Street 1:2339 ROUTE 70 W FL 4
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-3315
Practice Address - Country:US
Practice Address - Phone:856-546-8525
Practice Address - Fax:856-546-8527
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR18699000163WN0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0800XNursing Service ProvidersRegistered NurseNeuroscience