Individual provider · Type 1 NPI

Elyse Fearon

Gerontology Nurse Practitioner · Bloomfield, NJ

NPI number 1720896491 Active

Practice location

382 W Passaic Ave
Bloomfield, NJ 07003-5554

Mailing address

87 Union St
Cedar Grove, NJ 07009-1925

Specialties and licenses

TaxonomyCodeLicense
Primary Care Nurse Practitioner 363LP2300X26NJ15226200 (NJ)
Gerontology Nurse Practitioner Primary 363LG0600X26NJ15226200 (NJ)

Gerontology Nurse Practitioner: Definition to come...

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About NPI 1720896491

Elyse Fearon's National Provider Identifier is 1720896491, issued on Dec 26, 2024. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Bloomfield, NJ. The record was last updated on Dec 26, 2024.