Healthcare Provider Details

I. General information

NPI: 1528244944
Provider Name (Legal Business Name): MARYLOU NACE CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2008
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 SAND HILL RD STE 202
FLEMINGTON NJ
08822-4946
US

IV. Provider business mailing address

215 STATE ROUTE 31 RM 116
FLEMINGTON NJ
08822-5752
US

V. Phone/Fax

Practice location:
  • Phone: 908-237-4080
  • Fax:
Mailing address:
  • Phone: 908-284-1125
  • Fax: 908-237-6057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberNJ00140300
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number26NJ00140300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: