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General NPI Number Information
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NPI Number | 1477138378
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Entity Type | Individual
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Provider Name | PATIENCE ENABOSI REGISTERED NURSE
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Gender | Female
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Dates
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Enumeration Date | 03/11/2021
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 117 POND AVE
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City | MIDDLESEX
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State | NJ
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Zip | 08846-2218
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Country | US
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Telephone | 862-216-9966
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Fax |
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Provider Business Mailing Address
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Address Line | 185 CENTRAL AVE STE 607D
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City | EAST ORANGE
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State | NJ
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Zip | 07018-3332
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Country | US
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Telephone | 732-857-1978
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2024087196
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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