Healthcare Provider Details

I. General information

NPI: 1154086270
Provider Name (Legal Business Name): STAR NWAMAKA OPARA FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2021
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 WASHINGTON AVE
LINDEN NJ
07036-2950
US

IV. Provider business mailing address

930 WASHINGTON AVE
LINDEN NJ
07036-2950
US

V. Phone/Fax

Practice location:
  • Phone: 862-902-3905
  • Fax:
Mailing address:
  • Phone: 862-902-3905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ15578200
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR1351800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: