Provider Demographics
NPI:1619328663
Name:GARCIA, NATHIFA AISHA (APN)
Entity Type:Individual
Prefix:MS
First Name:NATHIFA
Middle Name:AISHA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:NATHIFA
Other - Middle Name:AISHA
Other - Last Name:ST JOHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0330
Practice Address - Street 1:1601 HADDON AVE
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-3109
Practice Address - Country:US
Practice Address - Phone:856-757-3840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-30
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ223361862261QA1903X
NJ26NJ00624800363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical