Healthcare Provider Details

I. General information

NPI: 1407719057
Provider Name (Legal Business Name): KAITLYN ROSSI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 RUPELL RD
HAMPTON NJ
08827-4017
US

IV. Provider business mailing address

18 FOREST RIDGE DR
HACKETTSTOWN NJ
07840-0031
US

V. Phone/Fax

Practice location:
  • Phone: 908-847-7060
  • Fax:
Mailing address:
  • Phone: 908-217-7365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number26NJ15479800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: