MEDICARE: MS. JANET PATRICIA MCMAHON ACNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	26NJ00078200	NJ

General Provider Information

NPI Number	:	1164653960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANET PATRICIA MCMAHON ACNP

Provider Business Mailing Address
First Line	:	63 BRITTON RD
Second Line	:
City	:	STOCKTON
State	:	NJ
Zip	:	08559-1007
Country	:	US
Telephone Number	:	908-788-1069
Fax Number	:

Provider Business Practice Location Address
First Line	:	63 BRITTON RD
Second Line	:
City	:	STOCKTON
State	:	NJ
Zip	:	08559-1007
Country	:	US
Telephone Number	:	908-788-1069
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2009
Last Update Date	:	07/28/2009

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