Basic Information
| Provider Information | |||||||||
| NPI: | 1083829196 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EUSTICE | ||||||||
| FirstName: | MARIA | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 185 ROSEBERRY ST | ||||||||
| Address2: | FARLEY BLDG 2ND FLOOR | ||||||||
| City: | PHILLIPSBURG | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08865 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9088473991 | ||||||||
| FaxNumber: | 8335415800 | ||||||||
| Practice Location | |||||||||
| Address1: | 187 COUNTY ROAD 519 STE 2 | ||||||||
| Address2: | |||||||||
| City: | BELVIDERE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07823 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9088473991 | ||||||||
| FaxNumber: | 8335415800 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2007 | ||||||||
| LastUpdateDate: | 07/19/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 26NJ00057900 | NJ | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | SP007999 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.