Individual provider · Type 1 NPI
Kirkwood Bodden Sr.
Nurse Practitioner · Newark, NJ
Practice location
150 Bergen St
Newark, NJ 07103-2496
Mailing address
2106 Ackmen Ct
Bridgewater, NJ 08807-3558
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 26NJ00644200 (NJ) |
| Nurse Practitioner Primary | 363L00000X | 26NR16031700 (NJ) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1497237796
Kirkwood Bodden Sr.'s National Provider Identifier is 1497237796, issued on Sep 4, 2018. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Newark, NJ. The record was last updated on Oct 23, 2019.