Individual
MS. JESSICA E HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
32 CORBETT WAY, EATONTOWN, NJ 07724-2263
(732) 460-9555
(732) 460-0699
Mailing address
32 CORBETT WAY, EATONTOWN, NJ 07724-2263
(732) 460-9555
(732) 460-0699
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
25MP00230400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MP00230400
NJ LICENSE NUMBER
NJ
Enumeration date
12/14/2009
Last updated
03/16/2012
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