Healthcare Provider Details

I. General information

NPI: 1780790915
Provider Name (Legal Business Name): ERMA MORALES MUYUELA APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERMA M. MORALES R.N. APN-C

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 09/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 SPARTA AVE STE 207
SPARTA NJ
07871-1791
US

IV. Provider business mailing address

89 SPARTA AVE STE 207
SPARTA NJ
07871-1791
US

V. Phone/Fax

Practice location:
  • Phone: 973-940-8780
  • Fax: 973-726-3568
Mailing address:
  • Phone: 973-940-8780
  • Fax: 973-726-3568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NN05257600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: