Provider Demographics
NPI:1871855437
Name:RHODES, JENNIFER LYNN (MSN, FNP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYNN
Last Name:RHODES
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:HART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:191 MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-4005
Mailing Address - Country:US
Mailing Address - Phone:973-403-3212
Mailing Address - Fax:
Practice Address - Street 1:191 MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:NORTH CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-4005
Practice Address - Country:US
Practice Address - Phone:973-403-3212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00381500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily