Individual
JESSE PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2391 HIGHWAY 36, ATLANTIC HIGHLANDS, NJ 07716-2532
(848) 488-2200
(848) 300-5194
Mailing address
4701 MEGILL RD, WALL TOWNSHIP, NJ 07753-6923
(732) 856-2378
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
25MP00804100
NJ
363AM0700X
Medical Physician Assistant
Primary
25MP00804100
NJ
Other
Enumeration date
08/21/2023
Last updated
05/02/2024
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