Provider Demographics
NPI:1578319273
Name:EVANS, JESSICA HELEN (APN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:HELEN
Last Name:EVANS
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 1:24 SHARK RIVER RD
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-7419
Mailing Address - Country:US
Mailing Address - Phone:732-556-7424
Mailing Address - Fax:
Practice Address - Street 1:24 SHARK RIVER RD
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07753-7419
Practice Address - Country:US
Practice Address - Phone:732-556-7424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15046800363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology