Provider Demographics
NPI:1366021222
Name:JAMES, TINA MARIE (MSN, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:TINA MARIE
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 RIVER ST STE 901
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-5989
Mailing Address - Country:US
Mailing Address - Phone:516-505-7200
Mailing Address - Fax:
Practice Address - Street 1:221 RIVER ST STE 901
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-5989
Practice Address - Country:US
Practice Address - Phone:516-505-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR17629700163W00000X
NJ26NJ01138800363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0793523Medicaid