=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588439772
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CATHERINE J BIRD AGPCNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/17/2023
-----------------------------------------------------
Last Update Date | 08/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1140 ROUTE 72 W
-----------------------------------------------------
City | MANAHAWKIN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08050-2412
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-978-3397
-----------------------------------------------------
Fax | 732-922-6026
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 226 RTE 37 W STE 6
-----------------------------------------------------
City | TOMS RIVER
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08755-8047
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-930-2611
-----------------------------------------------------
Fax | 732-930-2828
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | 26NJ14968400
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LG0600X
-----------------------------------------------------
Taxonomy Name | Gerontology Nurse Practitioner
-----------------------------------------------------
License Number | 26NJ14968400
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 26NJ14968400
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------