Provider Demographics
NPI:1467593137
Name:O'NEILL, JENNIFER ANN (RN,APN,C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:RN,APN,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 EISENHOWER PKWY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-1718
Mailing Address - Country:US
Mailing Address - Phone:973-716-9600
Mailing Address - Fax:973-716-9650
Practice Address - Street 1:316 EISENHOWER PKWY
Practice Address - Street 2:SUITE 202
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-1718
Practice Address - Country:US
Practice Address - Phone:973-716-9600
Practice Address - Fax:973-716-9650
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00000300363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NJ00000300OtherLICENSE