Provider Demographics
NPI:1356711550
Name:AKOMBE, JELIAH N (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:JELIAH
Middle Name:N
Last Name:AKOMBE
Suffix:
Gender:
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 1:6 BRIARWOOD CT
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-1803
Mailing Address - Country:US
Mailing Address - Phone:732-527-5519
Mailing Address - Fax:
Practice Address - Street 1:6 BRIARWOOD CT
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-1803
Practice Address - Country:US
Practice Address - Phone:732-527-5519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-30
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00582200163WW0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner