Healthcare Provider Details

I. General information

NPI: 1255214326
Provider Name (Legal Business Name): JILLIAN CONLEY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2025
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 JACK MARTIN BLVD
BRICK NJ
08724-7732
US

IV. Provider business mailing address

1509 SPRUCE AVE
OCEAN NJ
07712-4221
US

V. Phone/Fax

Practice location:
  • Phone: 732-212-0060
  • Fax:
Mailing address:
  • Phone: 732-865-3400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number26NR18788700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: