Provider Demographics
NPI:1194356972
Name:BUILES, ANA MARIEL (FNP-C)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:MARIEL
Last Name:BUILES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:552 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:NJ
Mailing Address - Zip Code:07644-1137
Mailing Address - Country:US
Mailing Address - Phone:973-981-3635
Mailing Address - Fax:
Practice Address - Street 1:552 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:NJ
Practice Address - Zip Code:07644-1137
Practice Address - Country:US
Practice Address - Phone:973-981-3635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00968100363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily