Provider Demographics
NPI:1205395506
Name:ARISTIZABAL, JESSICA (APRN-CNP)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:ARISTIZABAL
Suffix:
Gender:
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 SCHULZ DR STE 2
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-6745
Mailing Address - Country:US
Mailing Address - Phone:732-333-8720
Mailing Address - Fax:848-800-4801
Practice Address - Street 1:331 NEWMAN SPRINGS ROAD
Practice Address - Street 2:BUILDING 2, FLOOR1, SUITE 200
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701
Practice Address - Country:US
Practice Address - Phone:732-426-3420
Practice Address - Fax:848-800-4801
Is Sole Proprietor?:No
Enumeration Date:2019-03-16
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00907000363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0872512Medicaid
NJ6315466OtherAETNA
NJ7832351OtherCIGNA