Provider Demographics
NPI:1871130898
Name:TUMOSA, HOLLIE ANN
Entity type:Individual
Prefix:
First Name:HOLLIE
Middle Name:ANN
Last Name:TUMOSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 FARM LN
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-2351
Mailing Address - Country:US
Mailing Address - Phone:732-895-4571
Mailing Address - Fax:
Practice Address - Street 1:10 FARM LN
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-2351
Practice Address - Country:US
Practice Address - Phone:732-895-4571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-09
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR13111500163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse