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General NPI Number Information
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NPI Number | 1124447024
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Entity Type | Individual
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Provider Name | VIVIAN ADIELE
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Gender | Female
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Dates
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Enumeration Date | 04/08/2014
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 201 STRYKERS RD STE 19-218
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City | PHILLIPSBURG
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State | NJ
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Zip | 08865-5400
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Country | US
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Telephone | 908-514-4331
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Fax |
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Provider Business Mailing Address
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Address Line | 201 STRYKERS RD STE 19-218
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City | PHILLIPSBURG
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State | NJ
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Zip | 08865-5400
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Country | US
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Telephone | 908-514-4331
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Fax | 908-270-2557
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | SP029429
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | SP014867
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 26NJ00569000
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License Number State | NJ
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