Individual
JILLIAN K TARDIF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN-C
Contact information
Practice address
485 WILLIAMSTOWN NEW FREEDOM RD, SICKLERVILLE, NJ 08081-1777
(856) 237-8100
(856) 237-8042
Mailing address
485 WILLIAMSTOWN NEW FREEDOM RD, SICKLERVILLE, NJ 08081-1777
(856) 237-8100
(856) 237-8042
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ00401200
NJ
363LF0000X
Family Nurse Practitioner
26NR15387300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123456789
PENDING MEDICAL LICENSE
NJ
Enumeration date
09/17/2012
Last updated
03/10/2015
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