Individual
MRS. HUBERLINE EXANTUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
19 PROSPECT ST, SUMMIT, NJ 07901-2530
(973) 735-4796
Mailing address
107 EASTERN PKWY, HILLSIDE, NJ 07205-1753
(973) 735-4796
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR19040900
NJ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ01383500
NJ
Other
Enumeration date
10/24/2022
Last updated
10/24/2022
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