Healthcare Provider Details

I. General information

NPI: 1033127071
Provider Name (Legal Business Name): PATRICIA M STOUGHTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 11/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4361 ROUTE 42
TURNERSVILLE NJ
08012-1794
US

IV. Provider business mailing address

4361 ROUTE 42
TURNERSVILLE NJ
08012-1794
US

V. Phone/Fax

Practice location:
  • Phone: 856-885-4579
  • Fax:
Mailing address:
  • Phone: 856-885-4579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00095500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: