Provider Demographics
NPI:1194054379
Name:PELICAN, CATHY MARGARET (APN)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:MARGARET
Last Name:PELICAN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 NEPTUNE BLVD UNIT 2
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-4144
Mailing Address - Country:US
Mailing Address - Phone:732-775-5300
Mailing Address - Fax:732-775-1737
Practice Address - Street 1:444 NEPTUNE BLVD UNIT 2
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4144
Practice Address - Country:US
Practice Address - Phone:732-775-5300
Practice Address - Fax:732-775-1737
Is Sole Proprietor?:No
Enumeration Date:2009-12-16
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00253700363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily