Provider Demographics
NPI:1407538945
Name:PIERRE JEROME, ARDLY (RN, BSN)
Entity Type:Individual
Prefix:
First Name:ARDLY
Middle Name:
Last Name:PIERRE JEROME
Suffix:
Gender:M
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1806 HWY 35 STE 205E
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-2759
Mailing Address - Country:US
Mailing Address - Phone:732-610-4998
Mailing Address - Fax:
Practice Address - Street 1:1806 HWY 35 STE 205E
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-2759
Practice Address - Country:US
Practice Address - Phone:732-610-4998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR22717700163WM0705X
NJ26NR17655200163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical