Provider Demographics
NPI:1356095459
Name:VARGAS, BILLIE J (RN)
Entity Type:Individual
Prefix:MISS
First Name:BILLIE
Middle Name:J
Last Name:VARGAS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BILLIE
Other - Middle Name:J
Other - Last Name:VARGAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:12 JACQUES ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07201-2713
Mailing Address - Country:US
Mailing Address - Phone:201-931-6454
Mailing Address - Fax:
Practice Address - Street 1:6001 KENNEDY BLVD E
Practice Address - Street 2:
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-3729
Practice Address - Country:US
Practice Address - Phone:201-931-6454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR17071800364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist