Organization
SOUTHERN OCEAN REGISTERED NURSE FIRST ASSISTANT (RNFA),LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANNE MILLIGAN ARNP/C;RNFA (PRESIDENT)
(609) 597-4603
Entity
Organization
Contact information
Practice address
201 PETER RD, MANAHAWKIN, NJ 08050-3659
(609) 597-4603
Mailing address
201 PETER RD, MANAHAWKIN, NJ 08050-3659
(609) 597-4603
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
26N005034800
NJ
363LA2200X
Adult Health Nurse Practitioner
26NJ00009800
NJ
363LA2200X
Adult Health Nurse Practitioner
ARNP2016122
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0046655
—
NJ
01
—
054778ATW
MEDICARE ID-TYPE UNSPECIFIED
NJ
Enumeration date
05/22/2008
Last updated
05/22/2008
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