Provider Demographics
NPI:1669219846
Name:MOREIRA, CAROLINA (WHNP-BC)
Entity type:Individual
Prefix:
First Name:CAROLINA
Middle Name:
Last Name:MOREIRA
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 DONNA CT
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-3115
Mailing Address - Country:US
Mailing Address - Phone:201-621-3974
Mailing Address - Fax:
Practice Address - Street 1:955 S SPRINGFIELD AVE # A103
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-3570
Practice Address - Country:US
Practice Address - Phone:973-971-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15099000363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health