Provider Demographics
NPI:1477912863
Name:KOWALEWSKI, JESSICA A (MSN, RNC-OB, WHNP-BC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:A
Last Name:KOWALEWSKI
Suffix:
Gender:F
Credentials:MSN, RNC-OB, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:799 BLOOMFIELD AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-1301
Mailing Address - Country:US
Mailing Address - Phone:973-500-2399
Mailing Address - Fax:
Practice Address - Street 1:1060 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3638
Practice Address - Country:US
Practice Address - Phone:973-826-4920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00543100363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health