Basic Information
| Provider Information | |||||||||
| NPI: | 1447734488 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KAISER | ||||||||
| FirstName: | ANGELA | ||||||||
| MiddleName: | NICOLE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | CRNP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | LOMBARDI | ||||||||
| OtherFirstName: | ANGELA | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 600 CLEMENTS BRIDGE RD | ||||||||
| Address2: | |||||||||
| City: | BARRINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080071814 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5654780008 | ||||||||
| FaxNumber: | 8565471008 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 CLEMENTS BRIDGE RD | ||||||||
| Address2: | |||||||||
| City: | BARRINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080071814 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5654780008 | ||||||||
| FaxNumber: | 8565471008 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2018 | ||||||||
| LastUpdateDate: | 10/24/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 450410 | OH | N | Nursing Service Providers | Registered Nurse | 163W00000X | 645354 | PA | N | Nursing Service Providers | Registered Nurse | 363LF0000X | 023648 | OH | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | SP019289 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.