MRS. JENNIFER RANEE DEWILDE DC NPI 1306905054

NPI Information

NPI: 1306905054
Provider Name: MRS. JENNIFER RANEE DEWILDE, DC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
65 RAMAPO VALLEY RD STE 102B
MAHWAH, NJ
ZIP 07430
Phone: (732) 300-0833
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MRS. Jennifer Ranee Dewilde, DC is a family nurse practitioner in Mahwah, NJ. 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 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
1	363LF0000X	Nurse Practitioner	Family	F09231068	MISSOURI	Yes
2	111N00000X	Chiropractor		038010352	ILLINOIS	No

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
1	671268	OTHER	ILLINOIS	UNITED HEALTHCARE
2	038010352	MEDICAID	ILLINOIS
3	7932010	OTHER	ILLINOIS	BCBS

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: 5/5/2024

NPI Synchronization or Removal

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