Individual
CHANEL JETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
162 ELMORA AVE STE 416, ELIZABETH, NJ 07202-1148
(862) 262-1298
Mailing address
162 ELMORA AVE STE 416, ELIZABETH, NJ 07202-1148
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ15269800
NJ
Other
Enumeration date
02/12/2025
Last updated
02/12/2025
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