Individual
EVAN JAEP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
65 W JIMMIE LEEDS RD, POMONA, NJ 08240-9102
(609) 652-1000
Mailing address
12 STAFFORD PL, SICKLERVILLE, NJ 08081-3028
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
26NR16114800
NJ
Other
Enumeration date
06/06/2017
Last updated
06/06/2017
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