Healthcare Provider Details

I. General information

NPI: 1366009854
Provider Name (Legal Business Name): JANIE KLUG APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2019
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LEXINGTON RD BUILDING B, SUITE 200
WOOLWICH TOWNSHIP NJ
08085
US

IV. Provider business mailing address

401 ROUTE 73 N STE 320
MARLTON NJ
08053-3426
US

V. Phone/Fax

Practice location:
  • Phone: 856-241-2111
  • Fax: 856-241-2243
Mailing address:
  • Phone: 856-895-4040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number26NJ00790100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberL1-0040424
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: