Provider Demographics
NPI:1750600300
Name:CAUCHON, JESSICA LAURA (NNP)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:LAURA
Last Name:CAUCHON
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:LAURA
Other - Last Name:FITZGERALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3001 D56
Mailing Address - Street 2:NEWBORN HEALTH ASSOCIATES
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043
Mailing Address - Country:US
Mailing Address - Phone:856-782-3300
Mailing Address - Fax:856-504-8029
Practice Address - Street 1:282 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-3322
Practice Address - Country:US
Practice Address - Phone:860-545-8950
Practice Address - Fax:860-545-8959
Is Sole Proprietor?:No
Enumeration Date:2010-05-21
Last Update Date:2024-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00289000363LN0000X
CT12.5003363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NR13712700OtherMEDICAL LICENSE
NJ26NJ00289000OtherMEDICAL LICENSE