Provider Demographics
NPI:1417546912
Name:ANDRE, JESSICA (DOULA)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:ANDRE
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 WALT WHITMAN WAY
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-2167
Mailing Address - Country:US
Mailing Address - Phone:609-423-5573
Mailing Address - Fax:
Practice Address - Street 1:16 W FRONT ST STE 220
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08608-2010
Practice Address - Country:US
Practice Address - Phone:609-695-1977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula