George Kofa Kieh, PMHNP

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Runnemede, NJ

NPI 1396313680 · NPPES record last updated Jul 16, 2026

Key facts

NPI
1396313680
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
26NJ01160100 (NJ)
Practice address
824 N Black Horse Pike
Runnemede, NJ 08078-1034
Phone
(215) 839-0801
NPI assigned
Jun 14, 2021
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9 Lalor St
Trenton, NJ 08611-3503

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NR01160100NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psychnic Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ01160100 NJ Yes

Addresses

Primary practice location

824 N Black Horse Pike
Runnemede, NJ 08078-1034

Mailing address

292 Applegarth Rd
Monroe Township, NJ 08831-3754
Phone (609) 532-9965

Other practice location 1

292 Applegarth Rd
Monroe Township, NJ 08831-3754
Phone (609) 860-2500

Other identifiers

IdentifierTypeStateIssuer
26NR01160100OtherNJFAMILY NURSE PRACTITIONER

Electronic endpoints

TypeEndpointUseAffiliation
SOAP URL SOAP Health Information Exchange (HIE)

Other providers in Runnemede, NJ

All providers in Runnemede, NJ · Psychiatric/Mental Health Nurse Practitioner in New Jersey

Sources for this page

Verify at the official NPI Registry.