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General NPI Number Information
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NPI Number | 1396989083
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Entity Type | Individual
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Provider Name | JAMIE ANN DEBOUNO NP-C
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Gender | Female
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Dates
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Enumeration Date | 04/24/2009
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Last Update Date | 12/04/2018
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Provider Practice Location Address
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Address Line | 1907 NEW RD
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City | NORTHFIELD
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State | NJ
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Zip | 08225-1545
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Country | US
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Telephone | 609-645-8884
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Fax |
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Provider Business Mailing Address
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Address Line | 151 FRIES MILL RD STE 202
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City | BLACKWOOD
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State | NJ
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Zip | 08012-2057
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Country | US
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Telephone | 855-727-2465
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 26NR129390000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN575581
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | SP010169
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP011146
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 26NJ00185000
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License Number State | NJ
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