MEDICARE: TARYN OAKLEY-WATSON APN

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	363LF0000X	Family Nurse Practitioner	26NJ01055700	NJ

General Provider Information

NPI Number	:	1962072884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARYN OAKLEY-WATSON APN

Provider Business Mailing Address
First Line	:	662 THOREAU TER
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-7269
Country	:	US
Telephone Number	:	201-259-8343
Fax Number	:

Provider Business Practice Location Address
First Line	:	96 MILLBURN AVE STE 202
Second Line	:
City	:	MILLBURN
State	:	NJ
Zip	:	07041-1941
Country	:	US
Telephone Number	:	201-259-8343
Fax Number	:

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

Provider Enumeration Date	:	07/01/2021
Last Update Date	:	07/01/2021

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