Healthcare Provider Details

I. General information

NPI: 1932043585
Provider Name (Legal Business Name): NANA KERSI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 BERGEN ST
NEWARK NJ
07103-2496
US

IV. Provider business mailing address

7-02 LAKE ST
FAIR LAWN NJ
07410-1535
US

V. Phone/Fax

Practice location:
  • Phone: 201-844-5428
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ15558600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: