Provider Demographics
NPI:1487917910
Name:DAISEY, CHRISTINE (NP)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:
Last Name:DAISEY
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 1:5401 HARDING HWY
Mailing Address - Street 2:SUITE 5
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330
Mailing Address - Country:US
Mailing Address - Phone:609-909-0200
Mailing Address - Fax:609-909-0267
Practice Address - Street 1:5401 HARDING HWY
Practice Address - Street 2:SUITE 5
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330
Practice Address - Country:US
Practice Address - Phone:609-909-0200
Practice Address - Fax:609-909-0267
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00361200363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health