Provider Demographics
NPI:1457523847
Name:PARRIS-ATWELL, GWYN MARY (APN-C)
Entity Type:Individual
Prefix:
First Name:GWYN
Middle Name:MARY
Last Name:PARRIS-ATWELL
Suffix:
Gender:F
Credentials:APN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1038 E CHESTNUT AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-5800
Mailing Address - Country:US
Mailing Address - Phone:856-575-4836
Mailing Address - Fax:
Practice Address - Street 1:1038 E CHESTNUT AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-5800
Practice Address - Country:US
Practice Address - Phone:856-575-4836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ363LF0000X363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily