Provider Demographics
NPI:1366009854
Name:KLUG, JANIE (APRN)
Entity Type:Individual
Prefix:
First Name:JANIE
Middle Name:
Last Name:KLUG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 ROUTE 73 N STE 320
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3426
Mailing Address - Country:US
Mailing Address - Phone:856-895-4040
Mailing Address - Fax:
Practice Address - Street 1:300 LEXINGTON RD
Practice Address - Street 2:BUILDING B, SUITE 200
Practice Address - City:WOOLWICH TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08085
Practice Address - Country:US
Practice Address - Phone:856-241-2111
Practice Address - Fax:856-241-2243
Is Sole Proprietor?:No
Enumeration Date:2019-05-21
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0040424363L00000X
NJ26NJ00790100363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner