Healthcare Provider Details

I. General information

NPI: 1609310788
Provider Name (Legal Business Name): PATRICIA MUNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2016
Last Update Date: 12/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

794 ACADEMY RD
CAPE MAY NJ
08204-4415
US

IV. Provider business mailing address

794 ACADEMY RD
CAPE MAY NJ
08204-4415
US

V. Phone/Fax

Practice location:
  • Phone: 201-396-6769
  • Fax:
Mailing address:
  • Phone: 201-396-6769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License NumberL1-0049484
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number26NO08303000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: