Provider Demographics
NPI:1760686802
Name:ATKINS, RAHSHIDA (PHD)
Entity Type:Individual
Prefix:MRS
First Name:RAHSHIDA
Middle Name:
Last Name:ATKINS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:RAHSHIDA
Other - Middle Name:
Other - Last Name:ATKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APN-C
Mailing Address - Street 1:5 BLOSSOM DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08638-2003
Mailing Address - Country:US
Mailing Address - Phone:612-659-7111
Mailing Address - Fax:
Practice Address - Street 1:890 BENNETTS MILLS RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-2736
Practice Address - Country:US
Practice Address - Phone:732-367-7530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2014-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00030900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ123015XVAMedicare UPIN