Queenella Wisner
Individual provider Active NPI Home Health Aide · Beverly, NJ
NPI 1083282149 · NPPES record last updated Jun 15, 2021
Key facts
- NPI
- 1083282149
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Aide 374U00000X
- Practice address
- 1020 Woodlane Rd Apt 70
Beverly, NJ 08010-3204 - Phone
- (267) 401-7675
- NPI assigned
- Jun 15, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Halo Heart Care LLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | Yes |
Addresses
Primary practice location
1020 Woodlane Rd Apt 70
Beverly, NJ 08010-3204
Mailing address
1020 Woodlane Rd Apt 70
Beverly, NJ 08010-3204
Phone (267) 401-7675
Other providers in Beverly, NJ
- Pathmark Stores Inc
- Precious One Home Healthcare Services LLC
- Elizabeth Purdy
- Rha Health Services NJ LLC
- Root to Vine Therapy
- Sheena Wright
All providers in Beverly, NJ · Home Health Aide in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.