Provider Demographics
NPI:1750111878
Name:MARCUS, PRUDENCE ANN (MSN, APRN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:PRUDENCE
Middle Name:ANN
Last Name:MARCUS
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 SCHINDLER DR N
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08852-3542
Mailing Address - Country:US
Mailing Address - Phone:732-979-1555
Mailing Address - Fax:
Practice Address - Street 1:1601 SCHINDLER DR N
Practice Address - Street 2:
Practice Address - City:MONMOUTH JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08852-3542
Practice Address - Country:US
Practice Address - Phone:732-979-1555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2023206548207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine