Provider Demographics
NPI:1184956294
Name:HARNEY, ETHLYN JUDY (RN)
Entity type:Individual
Prefix:
First Name:ETHLYN
Middle Name:JUDY
Last Name:HARNEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-2110
Mailing Address - Country:US
Mailing Address - Phone:973-251-2258
Mailing Address - Fax:
Practice Address - Street 1:33 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-2110
Practice Address - Country:US
Practice Address - Phone:973-251-2258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-01
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ81NR81163WH0200X
NJ374U00000X, 376J00000X
376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide