Provider Demographics
NPI:1508315581
Name:MASON, RENEE (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:
Last Name:MASON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2441 HIGHWAY 33
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753
Mailing Address - Country:US
Mailing Address - Phone:201-315-8937
Mailing Address - Fax:
Practice Address - Street 1:200 CENTRAL AVE
Practice Address - Street 2:APT D2
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-3057
Practice Address - Country:US
Practice Address - Phone:201-315-8937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00673100363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily