| Doctor Name: | JACLYN MARJORIE VALENTINE |
| NPI Number: | 1083950869 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.N., NP-C |
| License Number: | 26NJ00408200 |
| Business Practice Address: | 27 Pinckney Rd Red Bank, NJ - 077012179 |
| Business Phone Number: | 7327474600 |
| Business Fax Number: | 7322191968 |
| Mailing Address: | Po Box 8519, RED BANK |
| State: | NJ |
| Postal Code: | 077018519 |
| Phone Number: | 7324609840 |
| Fax Number: | 7324609848 |
| NPI Enumeration Date: | 12/23/2012 |
| NPI Last Update Date: | 04/03/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 26NJ00408200 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |