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General NPI Number Information
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NPI Number | 1124911821
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Entity Type | Individual
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Provider Name | TAHISHA JEAN
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Gender | Female
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Dates
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Enumeration Date | 05/31/2025
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Last Update Date | 05/31/2025
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Provider Practice Location Address
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Address Line | 230 POTTERSVILLE RD
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City | CHESTER
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State | NJ
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Zip | 07930-2432
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Country | US
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Telephone | 908-895-4931
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Fax |
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Provider Business Mailing Address
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Address Line | 3 JEAN ST # A2
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City | MORRISTOWN
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State | NJ
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Zip | 07960-2841
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Country | US
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Telephone | 908-884-4628
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Fax | 908-884-4628
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 26NR20500400
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License Number State | NJ
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