Kristal M Cannici, FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Dover, NJ
NPI 1174490122 · NPPES record last updated May 5, 2026
Key facts
- NPI
- 1174490122
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 26NJ15396200 (NJ)
- Practice address
- 375 E McFarlan St Ste 2
Dover, NJ 07801-3628 - Phone
- (973) 366-5859
- Fax
- (973) 366-0026
- NPI assigned
- Oct 22, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
465 S St
Suite 103
Morristown, NJ 07960
465 S St
Suite 103
Morristown, NJ 07960-6442
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260528001926 | NJ | Practitioner - Nurse Practitioner | 8224508551 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NJ15396200 | NJ | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 26NJ15396200 | NJ | Yes |
Addresses
Primary practice location
375 E McFarlan St Ste 2
Dover, NJ 07801-3628
Mailing address
PO Box 95000, LB#7550
Philadelphia, PA 19195-7550
Phone (844) 362-1735
Other practice location 1
703 Main St
Paterson, NJ 07503-2621
Phone (973) 754-2000
Other providers in Dover, NJ
- Neola Bricuyet
- Carmen Y Bustamante
- Werner Salvador Bustamante
- Lina Maria Calderon
- Andrea Campisano
- Shanna Canty
- Judith Caruso
- Gianna Castellano
- Monreo Castro
- Catholic Family & Community Services
All providers in Dover, NJ · Family Nurse Practitioner in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 5, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.