Provider Demographics
NPI:1548297237
Name:AUSTIN, JO E (NP-C)
Entity type:Individual
Prefix:
First Name:JO
Middle Name:E
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 JACK MARTIN BLVD STE D-1
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-7771
Mailing Address - Country:US
Mailing Address - Phone:732-458-5854
Mailing Address - Fax:732-458-8012
Practice Address - Street 1:210 JACK MARTIN BLVD STE D-1
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-7771
Practice Address - Country:US
Practice Address - Phone:732-458-5854
Practice Address - Fax:732-458-8012
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00089800363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health