Most Relevant Information
Provider Data
| NPI Number: | 1003281940 |
| Provider Name: | LORI BRAVENBOER FNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 26NJ00603500 |
Most Important Dates
| Enumeration Date: | 12/03/2015 |
| Last Updated: | 12/03/2015 |
Provider Practice Location
181 HIGH ST
NEWTON
NJ
078601020
Practice Location Phone/Fax
| Phone: | 9733839898 |
| Fax: |
Provider Mailing Location
22 HIDDEN VALLEY DR
VERNON
NJ
074623153
Provider Mailing Phone/Fax
| Phone: | 9732142334 |
| Fax: |