Healthcare Provider Details

I. General information

NPI: 1174570626
Provider Name (Legal Business Name): CINDY NUNAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 09/20/2022
Certification Date: 09/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4450 E. BLACK HORSE PIKE UNIT 3972
MAYS LANDING NJ
08330
US

IV. Provider business mailing address

1 E. NEW YORK AVE
SOMERS POINT NJ
08244
US

V. Phone/Fax

Practice location:
  • Phone: 609-365-6217
  • Fax: 609-926-4311
Mailing address:
  • Phone: 609-653-3265
  • Fax: 609-926-4311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00101900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: