Provider Demographics
NPI:1932317526
Name:KAUFMAN, AUDREY C (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:AUDREY
Middle Name:C
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 MARIGOLD CIRCLE
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234
Mailing Address - Country:US
Mailing Address - Phone:609-926-5850
Mailing Address - Fax:609-748-9075
Practice Address - Street 1:1907 NEW RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1545
Practice Address - Country:US
Practice Address - Phone:609-645-8884
Practice Address - Fax:609-645-9780
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNO105958163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ012658Medicare PIN