MS. KELLY NUSSBAUM (NPI# 1215229596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215229596 |
| Entity Type | Individual |
| Full Name | MS. KELLY NUSSBAUM |
| Other Name | MS. KELLY NUSSBAUM |
| Credential | APRN |
| Practice Address |
163 Engle St Ste 4a Englewood NJ 07631-2530 |
| Mailing Address |
9 Ricker Rd Kinnelon NJ 07405 |
| Practice Telephone | 2014084487 |
| Practice Fax Number | 8003523015 |
| Mailing Telephone | 9738388869 |
| Enumeration Date | 2011-05-05 |
| Last Update Date | 2011-05-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SP0809X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Adult |
26NC07471600 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
163 ENGLE ST STE 4A |
| City | ENGLEWOOD |
| State | NJ |
| Zip Code | 07631-2530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902813876 | Wei Wang | Psychiatry & Neurology | 163 Engle St Ste 4a, Englewood, NJ 07631-2530 | 2006-08-02 |
| 1669777280 | Psychiatric Care Professional Association | Psychiatry & Neurology | 163 Engle St Ste 4a, Englewood, NJ 07631-2530 | 2011-01-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447868922 | Sharmela Brijmohan | Student in an Organized Health Care Education/Training Program | 350 Engle Street Englewood Nj Department of Medicine, Englewood, NJ 07631 | 2020-07-21 |
| 1902422553 | Ross Tyrone Jensen Lavine | Student in an Organized Health Care Education/Training Program | 350 Engle Street, Department of Medicine, Englewood, NJ 07631 | 2020-06-19 |
| 1881235497 | Cbt and Psychodynamic Therapy Associates LLC | Social Worker | 245 Walnut Street, Englewood, NJ 07631 | 2019-10-04 |
| 1346895950 | Eb Care At Englewood, LLC | Assisted Living Facility | 412 South Van Brunt Street, Englewood, NJ 07631 | 2019-08-09 |
| 1730695727 | Maytal Elart | Spec/Tech, Cardiovascular | 151 E Palisades Ave, 16e, Englewood, NJ 07631 | 2017-12-28 |
| 1396259255 | Elizabeth Thottumalil Thomas | Counselor | 93 West Palisade Ave, Englewood, NJ 07631 | 2017-11-29 |
| 1992214381 | Englewood Orthopedics Group PC | Orthopaedic Surgery | 55 Smith St Unit 5653, Englewood, NJ 07631 | 2017-09-28 |
| 1639691579 | Jee Hoon Jang | Student in an Organized Health Care Education/Training Program | 350 Engle St., Englewood, NJ 07631 | 2017-07-12 |
| 1427570332 | Dan Ran Castillo | Student in an Organized Health Care Education/Training Program | 350 Engel Street, Engelwood, NJ 07631 | 2017-07-12 |
| 1275061392 | Thomas J Drexler | Counselor | 93 W. Palisades Ave, Englewood, NJ 07631 | 2017-06-02 |
| Find all providers in zip 07631 | ||||
| Taxonomy Code | 364SP0809X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health, Adult |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417138405 | Carol Ann Hutchens | Clinical Nurse Specialist | 68 Franklin St, Englewood, NJ 07631-3616 | 2007-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386119105 | Nancy Cursi-vogle | Clinical Nurse Specialist | 16 Kayser Ln, West Orange, NJ 07052-1151 | 2018-10-08 |
| 1841565801 | Well Path, LLC. | Clinical Nurse Specialist | 110 Sylvan Ave, Gloucester City, NJ 08030-1634 | 2012-03-09 |
| 1659543684 | Karen Angela Maxim | Clinical Nurse Specialist | 314 East State Street, Trenton, NJ 08608 | 2008-03-31 |
| 1225229321 | Wellness Group of New Jersey | Clinical Nurse Specialist | 400d Lake St, Suite 2, Ramsey, NJ 07446-1279 | 2007-08-05 |
| 1902027121 | Sue Kujalowicz | Clinical Nurse Specialist | 1935 Axton Ave, Union, NJ 07083 | 2007-05-02 |
| 1326261819 | Rosemarie G Marcus | Clinical Nurse Specialist | 240 Frisch Ct, Childrens Aid & Family Services Inc, Paramus, NJ 07652-5248 | 2007-04-11 |
| 1083762173 | Carol Joan Goldblatt I | Clinical Nurse Specialist | 117-119 Roosevelt Ave, Plainfield, NJ 07060 | 2007-01-08 |
| 1932277241 | Suzanne Drake | Clinical Nurse Specialist | 400 D Lake Street, Suite 2, Ramsey, NJ 07446-1243 | 2006-12-04 |
| 1740354554 | Mary Ann Lancaster | Clinical Nurse Specialist | 500 North Bridge Street, Richard Hall Community Mental Health Center, Bridgewater, NJ 08807 | 2006-11-20 |
| 1720178999 | Patricia Shadek | Clinical Nurse Specialist | 25 Lindsley Dr Ste 203, Morristown, NJ 07960 | 2006-10-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.