Individual provider · Type 1 NPI

Kelly Vanwyck

Family Nurse Practitioner · Randolph, NJ

NPI number 1104334655 Active

Practice location

477 Route 10 Ste 205
Randolph, NJ 07869-2144

Call (973) 560-9500 Map

Mailing address

700 Route 46 E Ste 450
Fairfield, NJ 07004-1583

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X26NJ00792600 (NJ)

Family Nurse Practitioner: Definition to come...

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About NPI 1104334655

Kelly Vanwyck's National Provider Identifier is 1104334655, issued on Jan 18, 2018. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Randolph, NJ. The record was last updated on Jan 18, 2018.