Provider Demographics
NPI:1962287763
Name:HURTADO, CARMEN JOSEPHINE (RN, MSN, NP)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:JOSEPHINE
Last Name:HURTADO
Suffix:
Gender:F
Credentials:RN, MSN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-9591
Mailing Address - Country:US
Mailing Address - Phone:732-851-7007
Mailing Address - Fax:
Practice Address - Street 1:400 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-9591
Practice Address - Country:US
Practice Address - Phone:732-851-7007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14921400363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health