Provider Demographics
NPI:1144845322
Name:COUPER, JESSICA L (CNM)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:COUPER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 SOUTH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6442
Mailing Address - Country:US
Mailing Address - Phone:203-449-7293
Mailing Address - Fax:
Practice Address - Street 1:11 OVERLOOK RD STE 210
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-3580
Practice Address - Country:US
Practice Address - Phone:973-971-4142
Practice Address - Fax:973-327-9767
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25ME00071100367A00000X
NJ25ME00071101367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife