Provider Demographics
NPI:1215508346
Name:DEEKEN, KRISTEN ELIZABETH (MSN RN PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:ELIZABETH
Last Name:DEEKEN
Suffix:
Gender:F
Credentials:MSN RN PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:687 ROUTE 9
Mailing Address - Street 2:
Mailing Address - City:BAYVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08721-2548
Mailing Address - Country:US
Mailing Address - Phone:732-269-4849
Mailing Address - Fax:
Practice Address - Street 1:687 ROUTE 9
Practice Address - Street 2:
Practice Address - City:BAYVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08721-2548
Practice Address - Country:US
Practice Address - Phone:732-269-4849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01169700363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health