Individual
MRS. JENNIFER RANEE DEWILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
65 RAMAPO VALLEY RD STE 102B, MAHWAH, NJ 07430-1182
(732) 300-0833
Mailing address
65 RAMAPO VALLEY RD STE 102B, MAHWAH, NJ 07430-1182
(732) 300-0833
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038010352
IL
363LF0000X
Family Nurse Practitioner
53-82718-091
KS
363LF0000X
Family Nurse Practitioner
Primary
F09231068
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038010352
—
IL
01
—
671268
UNITED HEALTHCARE
IL
01
—
7932010
BCBS
IL
Enumeration date
12/08/2006
Last updated
01/13/2026
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