Provider Demographics
NPI:1346012416
Name:GUERRERO, MERLITA CABCUNGAN (NP)
Entity Type:Individual
Prefix:
First Name:MERLITA
Middle Name:CABCUNGAN
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 PELICAN DR
Mailing Address - Street 2:
Mailing Address - City:BAYVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08721-1654
Mailing Address - Country:US
Mailing Address - Phone:732-930-3626
Mailing Address - Fax:
Practice Address - Street 1:53 PELICAN DR
Practice Address - Street 2:
Practice Address - City:BAYVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08721-1654
Practice Address - Country:US
Practice Address - Phone:732-930-3626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14940800363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner