Provider Demographics
NPI:1861557258
Name:TOY, KATHLEEN ROSE (MSN, APN, BC)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:ROSE
Last Name:TOY
Suffix:
Gender:F
Credentials:MSN, APN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:HADDON TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-3303
Mailing Address - Country:US
Mailing Address - Phone:856-858-6867
Mailing Address - Fax:
Practice Address - Street 1:201 LAUREL RD
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2329
Practice Address - Country:US
Practice Address - Phone:856-772-0152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN07508700363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ123028XVAMedicare UPIN