MEDICARE: FLORENCE GERMAIN AGACNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner	14341	WI
2	363LA2100X	Acute Care Nurse Practitioner	26NJ00833900	NJ

General Provider Information

NPI Number	:	1144716648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FLORENCE GERMAIN AGACNP

Provider Business Mailing Address
First Line	:	212 4TH ST
Second Line	:
City	:	HAZLET TOWNSHIP
State	:	NJ
Zip	:	07734-2918
Country	:	US
Telephone Number	:	732-829-4816
Fax Number	:

Provider Business Practice Location Address
First Line	:	212 4TH ST
Second Line	:
City	:	HAZLET TOWNSHIP
State	:	NJ
Zip	:	07734-2918
Country	:	US
Telephone Number	:	732-829-4816
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2018
Last Update Date	:	12/03/2025

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