Healthcare Provider Details

I. General information

NPI: 1528214004
Provider Name (Legal Business Name): JULIE ANN CHRISTJOHN-BRECKLEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2008
Last Update Date: 08/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

567 KINGS HIGHWAY
SOUTH SEAVILLE NJ
08246-0023
US

IV. Provider business mailing address

PO BOX 23
SOUTH SEAVILLE NJ
08246-0023
US

V. Phone/Fax

Practice location:
  • Phone: 609-624-9200
  • Fax:
Mailing address:
  • Phone: 609-624-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number26NR11774500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: