Healthcare Provider Details

I. General information

NPI: 1689489361
Provider Name (Legal Business Name): HILLARY WELLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2025
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 OLD HIGHWAY 22
CLINTON NJ
08809-1389
US

IV. Provider business mailing address

54 OLD HIGHWAY 22
CLINTON NJ
08809-1389
US

V. Phone/Fax

Practice location:
  • Phone: 908-730-6363
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number0001272598
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP031185
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ15277400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: