Unknown Individual – Psychiatric/Mental Health Registered Nurse, NPI 1790764991

Unknown Individual is a healthcare provider. based in Medford, New Jersey. specializing in Psychiatric/Mental Health Registered Nurse. They hold a License No. 26NO10558100 (NJ). The NPI Number for Unknown Individual is 1790764991

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1790764991
Phone
(609) 953-0939
Address
37 HAWKIN RD
Deactivation Date
23 August 2021
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Hawkin Road, Chairville, Medford Township, Burlington County, New Jersey, 08088, United States

    MEDFORD, NJ 080559414

    Phone: (609) 953-0939

    Fax: (609) 953-1664

    Type: Mailing

  • 101, Laurel Road East, Stratford, Camden County, New Jersey, 08084, United States

    STRATFORD, NJ 080841324

    Phone: (856) 566-6238

    Fax: (856) 566-6236

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 08055)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1790764991 for Unknown Individual, then check state licensing separately.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Psychiatric/Mental Health Registered Nurse. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Medford, New Jersey in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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