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NPI Code Detail

MEDICARE: MRS. CAMILLA THERESA ARTWELL-NICHOLSON FNP-C

MEDICARE:  MRS. CAMILLA THERESA ARTWELL-NICHOLSON  FNP-C
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
1363L00000XNurse Practitioner26NJ01279000NJ

General Provider Information

NPI Number : 1588306377
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CAMILLA THERESA ARTWELL-NICHOLSON FNP-C
Provider Business Mailing Address
First Line : 741 BROADWAY
Second Line :
City : NEWARK
State : NJ
Zip : 07104-4309
Country : US
Telephone Number : 973-483-1300
Fax Number :
Provider Business Practice Location Address
First Line : 741 BROADWAY
Second Line :
City : NEWARK
State : NJ
Zip : 07104-4309
Country : US
Telephone Number : 973-483-1300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2022
Last Update Date : 01/05/2026

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Directions to “ MRS. CAMILLA THERESA ARTWELL-NICHOLSON FNP-C” Practice Location

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