| Doctor Name: | MS. JOLENE RENEE GANIEL |
| NPI Number: | 1285936211 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP-C |
| License Number: | 26NJ00311700 |
| Business Practice Address: | 6410 New Jersey Ave Wildwood Crest, NJ - 082601216 |
| Business Phone Number: | 6095231331 |
| Business Fax Number: | 6095221516 |
| Mailing Address: | 103 Asbury Rd, EGG HARBOR TOWNSHIP |
| State: | NJ |
| Postal Code: | 082347104 |
| Phone Number: | 6097039596 |
| Fax Number: | |
| NPI Enumeration Date: | 11/24/2010 |
| NPI Last Update Date: | 11/24/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 26NJ00311700 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |