Provider Demographics
NPI:1801268826
Name:LECONTE, JENNIFER (MSN,RN,AGPCNP-C)
Entity type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:
Last Name:LECONTE
Suffix:
Gender:F
Credentials:MSN,RN,AGPCNP-C
Other - Prefix:
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Mailing Address - Street 1:331 NEWMAN SPRINGS RD STE 220
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5792
Mailing Address - Country:US
Mailing Address - Phone:732-807-0877
Mailing Address - Fax:201-751-1680
Practice Address - Street 1:77 VERONICA AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873
Practice Address - Country:US
Practice Address - Phone:732-246-1311
Practice Address - Fax:732-214-9657
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-29
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00599900363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1801268826Other520061