Healthcare Provider Details

I. General information

NPI: 1437878014
Provider Name (Legal Business Name): KATHY S CARRABBA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2022
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 HAWTHORNE LN
BARNEGAT NJ
08005-5641
US

IV. Provider business mailing address

225 HAWTHORNE LN
BARNEGAT NJ
08005-5641
US

V. Phone/Fax

Practice location:
  • Phone: 772-321-7690
  • Fax:
Mailing address:
  • Phone: 772-321-7690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ01356900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: