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General NPI Number Information
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NPI Number | 1184964868
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Entity Type | Organization
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Legal Business Name | SOUTH JERSEY NURSE PRACTITIONERS SERVICES
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Dates
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Enumeration Date | 02/18/2013
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Last Update Date | 03/26/2013
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Provider Practice Location Address
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Address Line | 100 N BLACK HORSE PIKE SUITE C
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City | BLACKWOOD
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State | NJ
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Zip | 08012-3042
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Country | US
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Telephone | 856-228-1989
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Fax | 856-228-1934
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Provider Business Mailing Address
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Address Line | 100 N BLACK HORSE PIKE SUITE C
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City | BLACKWOOD
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State | NJ
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Zip | 08012-3042
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Country | US
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Telephone | 856-228-1989
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Fax | 856-228-1934
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Authorized Official
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Title or Position | OWNER
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Name | HAJAH ONUOHA
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Credential | APN-BC
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Telephone | 856-228-1989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 26NJ00379200
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License Number State | NJ
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