Provider Demographics
NPI:1083849632
Name:CAMPOREALE, JAYNE M (APN-C, RN, OCN, MS)
Entity type:Individual
Prefix:
First Name:JAYNE
Middle Name:M
Last Name:CAMPOREALE
Suffix:
Gender:F
Credentials:APN-C, RN, OCN, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:66 W GILBERT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-4947
Mailing Address - Country:US
Mailing Address - Phone:732-212-0051
Mailing Address - Fax:732-212-0713
Practice Address - Street 1:195 LITTLE ALBANY ST
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1914
Practice Address - Country:US
Practice Address - Phone:732-253-3939
Practice Address - Fax:732-253-3952
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-27
Last Update Date:2009-06-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NN08197900363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ152011ZANLMedicare PIN