Individual
JEFFANNIE KRYSTEL TAN DUAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
41 N 11TH ST, KENILWORTH, NJ 07033-1519
(551) 689-3615
Mailing address
41 N 11TH ST, KENILWORTH, NJ 07033-1519
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR21080700
NJ
363LW0102X
Women's Health Nurse Practitioner
Primary
26NJ15441100
NJ
Other
Enumeration date
09/09/2024
Last updated
10/11/2025
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