Healthcare Provider Details

I. General information

NPI: 1568044790
Provider Name (Legal Business Name): LORI JONES-HARDEN APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2021
Last Update Date: 12/08/2023
Certification Date: 10/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 FEDERAL ST
CAMDEN NJ
08103-1539
US

IV. Provider business mailing address

817 FEDERAL ST
CAMDEN NJ
08103-1539
US

V. Phone/Fax

Practice location:
  • Phone: 856-541-8217
  • Fax:
Mailing address:
  • Phone: 856-263-9439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ01394700
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR19843400
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number26NJ01394700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: