Individual
NASHANDA BALOGUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGPCNP
Contact information
Practice address
28 VALLEY RD # 148, MONTCLAIR, NJ 07042-2709
(973) 559-4600
(855) 998-4358
Mailing address
28 VALLEY RD # 148, MONTCLAIR, NJ 07042-2709
(973) 559-4600
(855) 998-4358
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
SP013879
PA
363LG0600X
Gerontology Nurse Practitioner
Primary
26NJ15053300
NJ
363LP2300X
Primary Care Nurse Practitioner
SP013879
PA
Other
Enumeration date
07/30/2014
Last updated
01/13/2025
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