Provider Demographics
NPI:1932861424
Name:MARCHANT, JENNA ALEXANDRA (NP)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:ALEXANDRA
Last Name:MARCHANT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:
Other - Last Name:DRUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:401 ROUTE 73 N STE 320
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3426
Mailing Address - Country:US
Mailing Address - Phone:732-530-5515
Mailing Address - Fax:
Practice Address - Street 1:225 HIGHWAY 35, SUITE 102 RED BANK, NJ 07701
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701
Practice Address - Country:US
Practice Address - Phone:732-530-5515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-12
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01204200363LP0200X
NJ26NR19152000163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty
No163WP0200XNursing Service ProvidersRegistered NursePediatricsGroup - Single Specialty