Provider Demographics
NPI:1962072884
Name:OAKLEY-WATSON, TARYN (APN)
Entity type:Individual
Prefix:
First Name:TARYN
Middle Name:
Last Name:OAKLEY-WATSON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:TARYN
Other - Middle Name:
Other - Last Name:OAKLEY-WATSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APN
Mailing Address - Street 1:662 THOREAU TER
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-7269
Mailing Address - Country:US
Mailing Address - Phone:201-259-8343
Mailing Address - Fax:
Practice Address - Street 1:96 MILLBURN AVE STE 202
Practice Address - Street 2:
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1941
Practice Address - Country:US
Practice Address - Phone:201-259-8343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01055700363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily