Provider Demographics
NPI:1740928357
Name:TANGEN, AMARIS XARA (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:AMARIS
Middle Name:XARA
Last Name:TANGEN
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:MS
Other - First Name:AMARIS
Other - Middle Name:XARA
Other - Last Name:AMOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:287 TENNENT RD
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1028
Mailing Address - Country:US
Mailing Address - Phone:585-643-0390
Mailing Address - Fax:
Practice Address - Street 1:4390 ROUTE 130 STE A
Practice Address - Street 2:
Practice Address - City:WILLINGBORO
Practice Address - State:NJ
Practice Address - Zip Code:08046-1065
Practice Address - Country:US
Practice Address - Phone:609-773-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY349023363LF0000X
NJ26NJ01308600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily