Healthcare Provider Details

I. General information

NPI: 1942636725
Provider Name (Legal Business Name): AVRIL A KELDO NP,RN-BC,OCN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2013
Last Update Date: 01/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 EASTON AVE
NEW BRUNSWICK NJ
08901-1766
US

IV. Provider business mailing address

254 EASTON AVE
NEW BRUNSWICK NJ
08901-1766
US

V. Phone/Fax

Practice location:
  • Phone: 732-354-6595
  • Fax:
Mailing address:
  • Phone: 732-354-6595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberP00396100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: