Basic Information
| Provider Information | |||||||||
| NPI: | 1992817647 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOBLEY | ||||||||
| FirstName: | ALEESA | ||||||||
| MiddleName: | MAE | ||||||||
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| Credential: | PHD RN APN CPHQ | ||||||||
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| Mailing Information | |||||||||
| Address1: | 42 E LAUREL RD STE 1700 | ||||||||
| Address2: | |||||||||
| City: | STRATFORD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080841354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8565667020 | ||||||||
| FaxNumber: | 8565666956 | ||||||||
| Practice Location | |||||||||
| Address1: | 42 E LAUREL RD STE 1700 | ||||||||
| Address2: | |||||||||
| City: | STRATFORD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080841354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8565667020 | ||||||||
| FaxNumber: | 8565666956 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 02/04/2019 | ||||||||
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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 | 363LA2200X | 26NN06140900 | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.