Provider Demographics
NPI:1740081942
Name:TABOBO, KARLA ANNE BAXTER (RN)
Entity type:Individual
Prefix:
First Name:KARLA ANNE
Middle Name:BAXTER
Last Name:TABOBO
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:KARLA ANNE
Other - Middle Name:JARDELEZA
Other - Last Name:BAXTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MINE HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:07803-2905
Mailing Address - Country:US
Mailing Address - Phone:973-306-9969
Mailing Address - Fax:
Practice Address - Street 1:16 1ST ST
Practice Address - Street 2:
Practice Address - City:MINE HILL
Practice Address - State:NJ
Practice Address - Zip Code:07803-2905
Practice Address - Country:US
Practice Address - Phone:973-306-9969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR25785100163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse