Individual
MISS JESSICA L CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9501 VENTNOR AVE, MARGATE CITY, NJ 08402-2218
(609) 823-6161
(609) 823-3413
Mailing address
13421 KELVIN AVE, PHILADELPHIA, PA 19116-1327
(267) 474-6792
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
25MP00088900
NJ
Other
Enumeration date
09/25/2006
Last updated
07/08/2007
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