MEDICARE: BRANDI MARIE BORKE

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	363LF0000X	Family Nurse Practitioner	26NJ01445200	NJ

General Provider Information

NPI Number	:	1548958259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDI MARIE BORKE

Provider Business Mailing Address
First Line	:	396 HIGH CREST DR
Second Line	:
City	:	WEST MILFORD
State	:	NJ
Zip	:	07480-3740
Country	:	US
Telephone Number	:	908-338-5190
Fax Number	:

Provider Business Practice Location Address
First Line	:	396 HIGH CREST DR
Second Line	:
City	:	WEST MILFORD
State	:	NJ
Zip	:	07480-3740
Country	:	US
Telephone Number	:	908-338-5190
Fax Number	:

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

Provider Enumeration Date	:	05/01/2023
Last Update Date	:	05/01/2023

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Directions to “ BRANDI MARIE BORKE ” Practice Location

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