Provider Demographics
NPI:1013903954
Name:FERNANDEZ, CAROLYN ANN (RN, MSN, APRN-BC)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:ANN
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:RN, MSN, APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 STATE ROUTE 37 W FL 2
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-8023
Mailing Address - Country:US
Mailing Address - Phone:732-736-0300
Mailing Address - Fax:732-736-9600
Practice Address - Street 1:250 STATE ROUTE 37 W FL 2
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755
Practice Address - Country:US
Practice Address - Phone:732-736-0300
Practice Address - Fax:732-736-9600
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN09093100207VM0101X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine