Healthcare Provider Details

I. General information

NPI: 1164150116
Provider Name (Legal Business Name): RENEE ROJAS APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2022
Last Update Date: 08/09/2022
Certification Date: 08/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 KINGS HWY STE 100
WEST DEPTFORD NJ
08096-3162
US

IV. Provider business mailing address

831 KINGS HWY
WEST DEPTFORD NJ
08096-3162
US

V. Phone/Fax

Practice location:
  • Phone: 856-853-8730
  • Fax:
Mailing address:
  • Phone: 856-853-8730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ01335200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: