Healthcare Provider Details

I. General information

NPI: 1083829196
Provider Name (Legal Business Name): MARIA EUSTICE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 07/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

187 COUNTY ROAD 519 STE 2
BELVIDERE NJ
07823
US

IV. Provider business mailing address

185 ROSEBERRY ST FARLEY BLDG 2ND FLOOR
PHILLIPSBURG NJ
08865
US

V. Phone/Fax

Practice location:
  • Phone: 908-847-3991
  • Fax: 833-541-5800
Mailing address:
  • Phone: 908-847-3991
  • Fax: 833-541-5800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00057900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP007999
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: