Provider Demographics
NPI:1619265857
Name:VELARDE, JANE RUIVIVAR (BSN,RN)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:RUIVIVAR
Last Name:VELARDE
Suffix:
Gender:F
Credentials:BSN,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-2715
Mailing Address - Country:US
Mailing Address - Phone:908-248-1258
Mailing Address - Fax:
Practice Address - Street 1:47 MADISON ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-2715
Practice Address - Country:US
Practice Address - Phone:908-248-1258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-20
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR12309000163W00000X, 163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163W00000XNursing Service ProvidersRegistered Nurse