Provider Demographics
NPI:1174003313
Name:TOMMAS, JENNA LEE (APN)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:LEE
Last Name:TOMMAS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 PINEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2537
Mailing Address - Country:US
Mailing Address - Phone:732-232-4892
Mailing Address - Fax:
Practice Address - Street 1:148 PINEWOOD RD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2537
Practice Address - Country:US
Practice Address - Phone:732-232-4892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00845800363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care