Provider Demographics
NPI:1083829196
Name:EUSTICE, MARIA (CRNP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:EUSTICE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 ROSEBERRY ST
Mailing Address - Street 2:FARLEY BLDG 2ND FLOOR
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865
Mailing Address - Country:US
Mailing Address - Phone:908-847-3991
Mailing Address - Fax:833-541-5800
Practice Address - Street 1:187 COUNTY ROAD 519 STE 2
Practice Address - Street 2:
Practice Address - City:BELVIDERE
Practice Address - State:NJ
Practice Address - Zip Code:07823
Practice Address - Country:US
Practice Address - Phone:908-847-3991
Practice Address - Fax:833-541-5800
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00057900363LF0000X
PASP007999363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily