Provider Demographics
NPI:1750582060
Name:VAN BUITENEN, NANCY (CCRN APN C)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:VAN BUITENEN
Suffix:
Gender:F
Credentials:CCRN APN C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6F BROOKSIDE HTS
Mailing Address - Street 2:
Mailing Address - City:WANAQUE
Mailing Address - State:NJ
Mailing Address - Zip Code:07465-1624
Mailing Address - Country:US
Mailing Address - Phone:973-835-0586
Mailing Address - Fax:201-996-4937
Practice Address - Street 1:30 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1914
Practice Address - Country:US
Practice Address - Phone:201-336-8310
Practice Address - Fax:201-996-4937
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO07353500363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health