Healthcare Provider Details

I. General information

NPI: 1881760437
Provider Name (Legal Business Name): NIVIA NIVIA PHILLIPS APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NIVIA NIVIA ROWE APN

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 JOHN F KENNEDY WAY
WILLINGBORO NJ
08046-1262
US

IV. Provider business mailing address

1 FEDERAL ST STE 200
CAMDEN NJ
08103-1088
US

V. Phone/Fax

Practice location:
  • Phone: 609-835-2838
  • Fax:
Mailing address:
  • Phone: 848-288-6935
  • Fax: 732-790-0107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ00121400
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ00121400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: