Individual
MRS. JESSICA L AVELLINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE
Contact information
Practice address
2250 HICKORY RD, SUITE 240, PLYMOUTH MEETING, PA 19462-1047
(609) 387-7322
(609) 387-7540
Mailing address
1110 MARLOU AVE, EGG HARBOR TOWNSHIP, NJ 08234-7534
(609) 601-1026
(609) 601-1039
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
26NP04959900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26NP04959900
STATE BOARD NURSING
NJ
Enumeration date
10/22/2007
Last updated
10/22/2007
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