Individual
JESSICA KETHLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
333 BROAD ST, RED BANK, NJ 07701-2178
(732) 852-2770
Mailing address
828 SOMERSET DR, TOMS RIVER, NJ 08753-5615
(732) 678-8510
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ01136100
NJ
Other
Enumeration date
04/03/2021
Last updated
05/06/2021
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