Doctor Name: | JENIFER MCEWAN |
NPI Number: | 1093144321 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN |
License Number: | 26NJ00471700 |
Business Practice Address: | 1945 Route 33 Neptune, NJ - 077534859 |
Business Phone Number: | 7327764546 |
Business Fax Number: | 7327764741 |
Mailing Address: | 1945 Route 33, NEPTUNE |
State: | NJ |
Postal Code: | 077534859 |
Phone Number: | 7327764546 |
Fax Number: | 7327764741 |
NPI Enumeration Date: | 11/07/2013 |
NPI Last Update Date: | 12/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LG0600X |
License Number: | 26NJ00471700 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Gerontology |
Taxonomy Definition: |