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General NPI Number Information
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NPI Number | 1619881323
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Entity Type | Organization
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Legal Business Name | CONSCIOUS NATIVES LLC
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Dates
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Enumeration Date | 09/30/2026
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Last Update Date | 09/30/2026
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Provider Practice Location Address
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Address Line | 204 ROSE HILL DR
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City | ABSECON
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State | NJ
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Zip | 08201-2502
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Country | US
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Telephone | 609-354-7542
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Fax | 936-241-0714
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Provider Business Mailing Address
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Address Line | 204 ROSE HILL DR
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City | ABSECON
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State | NJ
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Zip | 08201-2502
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Country | US
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Telephone | 609-354-7542
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Fax | 936-241-0714
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | DR. KEIANDRA VINSON
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Credential | DNP, MBA,PMHNP
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Telephone | 609-354-7542
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State | NULL
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