=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063269900
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMBER CAULFIELD APN, PMHNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/30/2024
-----------------------------------------------------
Last Update Date | 01/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 175 MADISON AVE FL 6
-----------------------------------------------------
City | MOUNT HOLLY
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08060-2099
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-355-7118
-----------------------------------------------------
Fax | 856-325-5222
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 301 LIPPINCOTT DR STE 410
-----------------------------------------------------
City | MARLTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08053-4197
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-355-7118
-----------------------------------------------------
Fax | 856-325-5222
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 26NJ15445200
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------