Individual
JENICA M KUKTELIONIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
3 COOPER PLZ, SUITE 411, CAMDEN, NJ 08103-1438
(856) 342-2270
(856) 365-1180
Mailing address
3 COOPER PLZ, SUITE 502, CAMDEN, NJ 08103-1438
(856) 342-3412
(856) 365-1180
Taxonomy
Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
NJ00166700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NJ00215100
MEDICAL LICENSE
NJ
Enumeration date
07/13/2009
Last updated
07/01/2024
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