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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. KIRKWOOD BODDEN SR.

Active Sole Proprietor

MR. KIRKWOOD BODDEN SR. is a Nurse Practitioner healthcare provider located in NEWARK, New Jersey. NPI 1497237796 is currently active in the NPPES registry. Verify at CMS.

Nurse Practitioner · NEWARK, NJ

Registration Details

NPI Number
1497237796
Provider Type
Individual
Gender
Male
NPI Issued
Sep 4, 2018 (7.9748979217035 yrs)
Last Updated
Oct 23, 2019
Licenses
26NJ00644200 (NJ)
26NR16031700 (NJ)
Sole Proprietor
Yes

Practice Information

Address
150 BERGEN ST
NEWARK, NJ, 071032496
Browse NJ providers · Browse ZIP 07103
Phone
9739726000
Primary Specialty
Nurse Practitioner
363L00000X
Additional Specialty
Nurse Practitioner

Other Nurse Practitioner Providers in NEWARK, NJ

Name Credential NPI
SOCORRO I. GALANO-ROGERS APN-C 1780615443
MRS. REGINA MARIE SCUTTI RN APN C 1679676746
MRS. IMELDA DE VERA GUIMARY NP 1073687760
MRS. GAIL BAKER APN 1639204043
MS. PATRICIA ANN PANFILE APN 1912022898
MR. HASSAN AYYASH 1336351303
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.