Provider Demographics
NPI:1568581569
Name:MCFADDEN, LOIS (RN)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:
Last Name:MCFADDEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 BOYDEN AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-2480
Mailing Address - Country:US
Mailing Address - Phone:973-378-6204
Mailing Address - Fax:973-378-6669
Practice Address - Street 1:180 BOYDEN AVE
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-2480
Practice Address - Country:US
Practice Address - Phone:973-378-6204
Practice Address - Fax:973-378-6669
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR03922200163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management