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General NPI Number Information
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NPI Number | 1245972215
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Entity Type | Individual
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Provider Name | ANGELA BOUTON FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/11/2022
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 3350 STATE ROUTE 138 STE 117
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City | WALL TOWNSHIP
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State | NJ
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Zip | 07719-9694
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Country | US
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Telephone | 732-280-2727
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Fax |
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Provider Business Mailing Address
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Address Line | 3350 STATE ROUTE 138 STE 117
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City | WALL TOWNSHIP
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State | NJ
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Zip | 07719-9694
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Country | US
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Telephone | 732-280-2727
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Fax |
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 26NJ01325000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363LX0106X
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Taxonomy Name | Occupational Health Nurse Practitioner
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License Number | 26NJ01325000
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 26NJ01325000
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 26NJ01325000
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License Number State | NJ
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ01325000
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License Number State | NJ
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