Provider Demographics
NPI:1316479991
Name:TAN, FLERIDA (DNP,FNP-C,APN-C)
Entity type:Individual
Prefix:DR
First Name:FLERIDA
Middle Name:
Last Name:TAN
Suffix:
Gender:F
Credentials:DNP,FNP-C,APN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 DARBY LN
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-1459
Mailing Address - Country:US
Mailing Address - Phone:609-513-9136
Mailing Address - Fax:609-476-2057
Practice Address - Street 1:37 DARBY LN
Practice Address - Street 2:
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-1459
Practice Address - Country:US
Practice Address - Phone:609-513-9136
Practice Address - Fax:609-476-2057
Is Sole Proprietor?:No
Enumeration Date:2017-04-01
Last Update Date:2017-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00719700363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care