Individual
JENNIFER WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
77 STANHOPE RD, SPARTA, NJ 07871-2238
(201) 245-0599
Mailing address
77 STANHOPE RD, SPARTA, NJ 07871-2238
(201) 245-0599
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ15470600
NJ
Other
Enumeration date
01/08/2026
Last updated
01/08/2026
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