Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 26NJ00638700 | NJ |
N | 363LG0600X | Nurse Practitioner - Gerontology | 26NJ00638700 | NJ |
N | 363LP2300X | Nurse Practitioner - Primary Care | 26NJ00638700 | NJ |
NPI | 1043669245 |
---|---|
Provider Name | Ms. Jorane Bonheur |
First Address | Newark, NJ 07104-4309 |
Second Address | Newark, NJ 07104-4309 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2016 |
Last Update Date | 29/07/2016 |