Healthcare Provider Details

I. General information

NPI: 1851632723
Provider Name (Legal Business Name): LUCILLE SCHOALES APN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2013
Last Update Date: 02/19/2021
Certification Date: 02/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 VOLVO DR
ROCKLEIGH NJ
07647-2508
US

IV. Provider business mailing address

9 1ST ST
CLOSTER NJ
07624-3008
US

V. Phone/Fax

Practice location:
  • Phone: 201-564-6009
  • Fax: 201-750-5086
Mailing address:
  • Phone: 201-664-3082
  • Fax: 201-664-3667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ00419900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: