Dibona, Destiny Michele

Dibona, Destiny Michele is an individual health care provider with primary practice located at 151 Fries Mill Rd Ste 301 , Turnersville NJ 08012-2016. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as her primary health care specialty. Dibona, Destiny Michele can be contacted via phone (856) 374-1881.

Contact Information

Primary practice address
151 Fries Mill Rd Ste 301 Turnersville NJ 08012-2016
Phone: (856) 374-1881
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 26NJ00933100 New Jersey

Profile Details

NPI number 1467094987
LBN Legal business name Dibona, Destiny Michele
Credentials AGACNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 16th, 2019
Last updated Feb 6th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467094987 NPPES
New Jersey MEDICAID 0712582

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