Provider Demographics
NPI:1407152564
Name:CUMMINGS, JO-ANN FIDES (RN, APN,C)
Entity Type:Individual
Prefix:MRS
First Name:JO-ANN
Middle Name:FIDES
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:RN, APN,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 BATES RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-2220
Mailing Address - Country:US
Mailing Address - Phone:732-363-1339
Mailing Address - Fax:
Practice Address - Street 1:211 SHREWSBURY AVE
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1250
Practice Address - Country:US
Practice Address - Phone:732-212-0777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN11355500363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics