Healthcare Provider Details

I. General information

NPI: 1083659536
Provider Name (Legal Business Name): PATRICIA MAHER-MEDIUCH RN, APN, C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 06/28/2023
Certification Date: 06/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 ROUTE 9 S STE 3
CAPE MAY COURT HOUSE NJ
08210-2343
US

IV. Provider business mailing address

2 RABBIT RUN
CAPE MAY NJ
08204-4423
US

V. Phone/Fax

Practice location:
  • Phone: 609-665-6242
  • Fax: 609-463-9798
Mailing address:
  • Phone: 609-463-9797
  • Fax: 609-463-9798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number26NC10613300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: