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NPI Code Detail

MEDICARE: DENISE OWEN-FABRICIUS CNS

MEDICARE:   DENISE  OWEN-FABRICIUS  CNS
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
1364SP0807XChild & Adolescent Psychiatric/Mental Health Clinical Nurse SpecialistNC69688NJ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1890000538OTHERNJRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346212826
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENISE OWEN-FABRICIUS CNS
Provider Business Mailing Address
First Line : 2250 CHAPEL AVE W
Second Line : SUITE 100
City : CHERRY HILL
State : NJ
Zip : 08002-2051
Country : US
Telephone Number : 856-482-9000
Fax Number : 856-482-1159
Provider Business Practice Location Address
First Line : 2250 CHAPEL AVE W
Second Line : SUITE 100
City : CHERRY HILL
State : NJ
Zip : 08002-2051
Country : US
Telephone Number : 856-482-9000
Fax Number : 856-482-1159
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2006
Last Update Date : 10/27/2014

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Directions to “ DENISE OWEN-FABRICIUS CNS” Practice Location

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