Provider Demographics
NPI:1811038144
Name:UMDNJ-SCHOOL OF NURSING
Entity Type:Organization
Organization Name:UMDNJ-SCHOOL OF NURSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FULL TIME FACULTY-INSTRUCTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:KATHERINE
Authorized Official - Last Name:KAULBACK
Authorized Official - Suffix:
Authorized Official - Credentials:MSN,RN
Authorized Official - Phone:856-566-6178
Mailing Address - Street 1:9 CLEMENTS HAND COURT
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081
Mailing Address - Country:US
Mailing Address - Phone:856-262-7289
Mailing Address - Fax:
Practice Address - Street 1:40 EAST LAUREL ROAD
Practice Address - Street 2:SUITE 2061
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084
Practice Address - Country:US
Practice Address - Phone:856-566-6178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR10704500251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)