Individual
MOLLY DEJESUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
105 MANHEIM AVE STE 7, BRIDGETON, NJ 08302-2139
(856) 451-4700
Mailing address
11 OSBORN LN, BRIDGETON, NJ 08302-4525
(856) 506-5693
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
26NJ01083000
NJ
Other
Enumeration date
11/24/2020
Last updated
11/24/2020
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