Provider Demographics
NPI:1104011238
Name:CWIKLINSKI, ANN M (RN,APN,C)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:M
Last Name:CWIKLINSKI
Suffix:
Gender:F
Credentials:RN,APN,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 12TH ST S
Mailing Address - Street 2:
Mailing Address - City:BRIGANTINE
Mailing Address - State:NJ
Mailing Address - Zip Code:08203-2211
Mailing Address - Country:US
Mailing Address - Phone:609-266-7557
Mailing Address - Fax:
Practice Address - Street 1:353 12TH ST S
Practice Address - Street 2:
Practice Address - City:BRIGANTINE
Practice Address - State:NJ
Practice Address - Zip Code:08203-2211
Practice Address - Country:US
Practice Address - Phone:609-266-7557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN05126100363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ049870Medicare PIN