Healthcare Provider Details

I. General information

NPI: 1548171689
Provider Name (Legal Business Name): ENEIDA LUZ PARKER CHES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 JERRICK CT
MOUNT LAUREL NJ
08054-9525
US

IV. Provider business mailing address

2 JERRICK CT
MOUNT LAUREL NJ
08054-9525
US

V. Phone/Fax

Practice location:
  • Phone: 760-622-5749
  • Fax:
Mailing address:
  • Phone: 760-622-5749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number23913
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: