Provider Demographics
NPI:1528405073
Name:NWOKONKO, ROLINDA CERVANTES (APN)
Entity Type:Individual
Prefix:
First Name:ROLINDA
Middle Name:CERVANTES
Last Name:NWOKONKO
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 WATCHUNG DR
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-4238
Mailing Address - Country:US
Mailing Address - Phone:908-532-0476
Mailing Address - Fax:
Practice Address - Street 1:47 WATCHUNG DR
Practice Address - Street 2:
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-4238
Practice Address - Country:US
Practice Address - Phone:908-532-0476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00438400363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care