Provider Demographics
NPI:1447231501
Name:VOSS, MARY AGNES (DNP, APN)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:AGNES
Last Name:VOSS
Suffix:
Gender:F
Credentials:DNP, APN
Other - Prefix:MS
Other - First Name:MOLLY
Other - Middle Name:
Other - Last Name:VOSS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DNP, APN
Mailing Address - Street 1:1255 CALDWELL RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-3220
Mailing Address - Country:US
Mailing Address - Phone:856-348-1209
Mailing Address - Fax:856-429-4755
Practice Address - Street 1:1000 WHITE HORSE RD STE 802
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4414
Practice Address - Country:US
Practice Address - Phone:856-524-7243
Practice Address - Fax:856-524-7365
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN04990500363LA2200X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8448108Medicaid
NJ26NN04990500OtherADVANCED PRACTICE NURSING
NJ26NN04990500OtherADVANCED PRACTICE NURSING
NJ8448108Medicaid
NJ26NN04990500OtherADVANCED PRACTICE NURSING
NJ223563877OtherTAX ID #