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NPI 1205040458

NPI 1205040458 : ROBERTA C SCUDDER MSN,RN,NP,C : WESTFIELD, NJ

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General NPI Number Information
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    NPI Number           |    1205040458
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    Entity Type          |    Individual 
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    Provider Name        |    ROBERTA C SCUDDER MSN,RN,NP,C
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/09/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    532 E BROAD ST 
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    City                 |    WESTFIELD
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    State                |    NJ
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    Zip                  |    07090-2116
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    Country              |    US
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    Telephone            |    908-232-8077
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    Fax                  |    908-232-8447
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Provider Business Mailing Address
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    Address Line         |    532 E BROAD ST 
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    City                 |    WESTFIELD
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    State                |    NJ
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    Zip                  |    07090-2116
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    Country              |    US
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    Telephone            |    908-232-8077
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    Fax                  |    908-232-8447
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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        |    163WP0200X
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    Taxonomy Name        |    Pediatric Registered Nurse
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    License Number       |    NN55500
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    License Number State |    NJ
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