MEDICARE: HEIDI CARLEY APRN, FNP-BC

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	363L00000X	Nurse Practitioner	26NJ15477000	NJ

General Provider Information

NPI Number	:	1396608279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEIDI CARLEY APRN, FNP-BC

Provider Business Mailing Address
First Line	:	373 DALLAS DR
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-4266
Country	:	US
Telephone Number	:	973-986-7840
Fax Number	:

Provider Business Practice Location Address
First Line	:	373 DALLAS DR
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-4266
Country	:	US
Telephone Number	:	973-986-7840
Fax Number	:

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

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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