Provider Demographics
NPI:1891031076
Name:ESTES, RENATA (APN)
Entity Type:Individual
Prefix:
First Name:RENATA
Middle Name:
Last Name:ESTES
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 US HIGHWAY 130
Mailing Address - Street 2:SUITE 103
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-2700
Mailing Address - Country:US
Mailing Address - Phone:609-448-7800
Mailing Address - Fax:609-448-7880
Practice Address - Street 1:375 US HIGHWAY 130
Practice Address - Street 2:SUITE 103
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-2700
Practice Address - Country:US
Practice Address - Phone:609-448-7800
Practice Address - Fax:609-448-7880
Is Sole Proprietor?:No
Enumeration Date:2012-12-17
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00406100363LW0102X
PASP012393363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASP012393OtherLICENSE
NJ26NJ00406100OtherLICENSE