Provider Demographics
NPI:1780912964
Name:CUNNIFF, CAROLINE ANNE (APN)
Entity type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:ANNE
Last Name:CUNNIFF
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 BANGS AVE
Mailing Address - Street 2:
Mailing Address - City:ASBURY PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-6902
Mailing Address - Country:US
Mailing Address - Phone:732-774-0262
Mailing Address - Fax:732-775-8963
Practice Address - Street 1:495 IRON BRIDGE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-3069
Practice Address - Country:US
Practice Address - Phone:732-577-0047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-25
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00252900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily