Provider Demographics
NPI:1184821191
Name:PROMISE, ANN (NP)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:
Last Name:PROMISE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 WOODGATE DR
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08852-3129
Mailing Address - Country:US
Mailing Address - Phone:732-940-8380
Mailing Address - Fax:
Practice Address - Street 1:888 EASTON AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-1898
Practice Address - Country:US
Practice Address - Phone:732-846-1763
Practice Address - Fax:732-846-1767
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00222200363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health