MRS. JENNIFER RANEE DEWILDE DC NPI 1306905054

NPI Information

  • NPI: 1306905054
  • Provider Name: MRS. JENNIFER RANEE DEWILDE, DC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 65 RAMAPO VALLEY RD STE 102B
    MAHWAH, NJ
    ZIP 07430
  • Phone: (732) 300-0833

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NPI Details

MRS. Jennifer Ranee Dewilde, DC is a family nurse practitioner in Mahwah, NJ with 3 years of experience. MRS. Jennifer Ranee Dewilde, DC NPI is 1306905054. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

65 RAMAPO VALLEY RD STE 102B
MAHWAH, NJ
ZIP 07430-182
Phone: (732) 300-0833

The NPI 1306905054 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/8/2006 and was last updated on 1/24/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyF09231068MISSOURIYes
2111N00000XChiropractor038010352ILLINOISNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1671268OTHERILLINOISUNITED HEALTHCARE
2038010352MEDICAIDILLINOIS
37932010OTHERILLINOISBCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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