PHYLLIS GLENN ANDERSON (NPI# 1154643500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154643500 |
| Entity Type | Individual |
| Full Name | PHYLLIS GLENN ANDERSON |
| Credential | ANP-BC |
| Practice Address |
610 Pemberton Browns Mills Rd Pemberton NJ 08068-1537 |
| Mailing Address |
271 Grove Ave Building E Verona NJ 07044-1730 |
| Practice Telephone | 6097264031 |
| Practice Fax Number | 6098948964 |
| Mailing Telephone | 9735719550 |
| Mailing Fax Number | 9735719747 |
| Enumeration Date | 2010-02-25 |
| Last Update Date | 2014-12-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
26NN06346100 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972920437 | Phyllis Anderson | Registered Nurse | 12124 High Tech Ave, Suite 300, Orlando, FL 32817-8373 | 2014-03-23 |
| 1548317712 | Phyllis Margo Anderson | Psychologist | 5675 Stone Rd, Suite 320, Centreville, VA 20120-1667 | 2007-01-03 |
| Street Address |
610 PEMBERTON BROWNS MILLS RD |
| City | PEMBERTON |
| State | NJ |
| Zip Code | 08068-1537 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710593579 | Jeana Ann Simko | Counselor | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2020-09-17 |
| 1457851107 | Maryville, Inc | Substance Abuse Rehabilitation Facility | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2018-02-20 |
| 1306346325 | Maryville, Inc | Substance Abuse Rehabilitation Facility | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068 | 2018-02-16 |
| 1396128955 | Legacy Treatment Services | Clinic/Center | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2015-07-01 |
| 1881085637 | Legacy Treatment Services | Substance Abuse Rehabilitation Facility | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2015-02-16 |
| 1962800367 | Orin H Morrison Jr. | Counselor | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2014-12-17 |
| 1790180438 | Kevin Ford | Counselor | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2014-10-23 |
| 1376944967 | Union Association of The Children's Home of Burlington County, Inc. | Clinic/Center | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2014-09-15 |
| 1881093920 | Union Assocation of The Children's Home of Burlington County, Inc. | Community/Behavioral Health | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2014-08-14 |
| 1902180037 | The Kintock Group of New Jersey, Inc. | Substance Abuse Rehabilitation Facility | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2011-10-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366998502 | Deena Gutch | Counselor | 610 Brownsmills Rd, Pemberton, NJ 08068 | 2016-08-28 |
| 1467738492 | Exceptional Kidz Rehabilitation | Counselor | 43 Elizabeth St, Pemberton, NJ 08068 | 2011-10-21 |
| 1972716603 | Ellen Christine Miller | Occupational Therapy Assistant | 600 Pemberton Browns-mills Road, Pemberton, NJ 08068 | 2007-05-08 |
| 1720236631 | Renuka Maringanti | Dentist | 600 Pemberton Browns Mills Rd, Pemberton, NJ 08068 | 2008-09-04 |
| 1053453076 | Chitra Sarvotam | Dentist | 600 Pemberton-browns Mills Road, Pemberton, NJ 08068 | 2007-02-13 |
| 1700182847 | E Estrella Wells | Student in an Organized Health Care Education/Training Program | 50 Budd Ave, Pemberton, NJ 08068-1104 | 2011-02-08 |
| 1417339128 | Jamie Reuter | Behavioral Analyst | 50 Budd Ave, Pemberton, NJ 08068-1104 | 2015-06-18 |
| 1710167614 | Stephen Alan Kloss | Pharmacist | 87 Hanover St, Pemberton, NJ 08068-1131 | 2007-11-07 |
| 1639291248 | Pemberton Township School District | Local Education Agency (LEA) | 1 Egbert St, Pemberton, NJ 08068-1211 | 2007-04-04 |
| 1851635791 | Aspired Living, Inc | Day Training, Developmentally Disabled Services | 43 Elizabeth St, Pemberton, NJ 08068-1215 | 2012-11-15 |
| Find all providers in zip 08068 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275133175 | Kristy Liekfet | Nurse Practitioner | Atlanticare Apg Palliative Care, 1925 Pacific Ave. 1st Flr, Atlantic City, NJ 08401 | 2020-10-29 |
| 1609476761 | Remya Uthup | Nurse Practitioner | 240 Main St Apt 418, Hackensack, NJ 07601-5745 | 2020-10-28 |
| 1083213524 | Joann Michelle Munoz | Nurse Practitioner | 11 Highland Pl, Ridgefield Park, NJ 07660-1203 | 2020-10-24 |
| 1669071775 | Destiny Medical Practice LLC | Nurse Practitioner | 10 Amara Ln, Westampton, NJ 08060-5753 | 2020-10-20 |
| 1912505918 | Lamercie Brasier | Nurse Practitioner | 55 Valley Way, West Orange, NJ 07052-5829 | 2020-10-12 |
| 1568069912 | Christine B Adams | Nurse Practitioner | 75 Lane Rd, Fairfield, NJ 07004-1044 | 2020-10-07 |
| 1255938361 | Maryjoy Marzan | Nurse Practitioner | Hope Tower - Jersey Shore University Medical Center, 19 Davis St 6th Floor, Neptune, NJ 07753 | 2020-10-02 |
| 1235746553 | Ellen Smith | Nurse Practitioner | 340 Airis Dr., Suite 203, Newark, NJ 07114 | 2020-09-30 |
| 1861009342 | Maria Angela Flores | Nurse Practitioner | 482 William Way N, Wyckoff, NJ 07481-1722 | 2020-09-28 |
| 1437764545 | Alison O'neill | Nurse Practitioner | 720 Monroe St Ste E407, Hoboken, NJ 07030-6356 | 2020-09-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.