Provider Demographics
NPI:1851804694
Name:DEELEY, LAURA JEAN (APN, FNP-BC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:JEAN
Last Name:DEELEY
Suffix:
Gender:
Credentials:APN, FNP-BC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:JEAN
Other - Last Name:CORNELIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:711 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028-1639
Mailing Address - Country:US
Mailing Address - Phone:856-794-1235
Mailing Address - Fax:
Practice Address - Street 1:711 N MAIN ST
Practice Address - Street 2:
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028-1639
Practice Address - Country:US
Practice Address - Phone:856-794-1235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-15
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00780000363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner