Provider Demographics
NPI:1679565865
Name:HUEGEL-CAPRO, KATHLEEN A (ANP)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:A
Last Name:HUEGEL-CAPRO
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HOSPITAL DR STE B1
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-6425
Mailing Address - Country:US
Mailing Address - Phone:732-363-7200
Mailing Address - Fax:866-662-4129
Practice Address - Street 1:9 HOSPITAL DR STE B1
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6425
Practice Address - Country:US
Practice Address - Phone:732-363-7200
Practice Address - Fax:866-662-4129
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ107422363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7906803Medicaid
NJ2797003Medicaid
NJ576878Medicaid
NJ025909ALKMedicare ID - Type Unspecified