Healthcare Provider Details

I. General information

NPI: 1326705740
Provider Name (Legal Business Name): PRISCA CHIMEZIE DNP, APRN PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2021
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 TOLER PL
NEWARK NJ
07114-1431
US

IV. Provider business mailing address

20 TOLER PL
NEWARK NJ
07114-1431
US

V. Phone/Fax

Practice location:
  • Phone: 862-215-2228
  • Fax:
Mailing address:
  • Phone: 862-215-2228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ01233400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: