Healthcare Provider Details

I. General information

NPI: 1245516632
Provider Name (Legal Business Name): JADRIAN DANELLE RAWLINGS FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2011
Last Update Date: 06/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

183 US HIGHWAY 206 S
CHESTER NJ
07930-2402
US

IV. Provider business mailing address

183 US HIGHWAY 206 S
CHESTER NJ
07930-2402
US

V. Phone/Fax

Practice location:
  • Phone: 908-879-6818
  • Fax:
Mailing address:
  • Phone: 908-879-6818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00354300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: