Healthcare Provider Details

I. General information

NPI: 1497336598
Provider Name (Legal Business Name): JESSENIA MARSH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2021
Last Update Date: 04/20/2021
Certification Date: 04/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 EDWARD AVE
HAMILTON NJ
08610-3904
US

IV. Provider business mailing address

253 EDWARD AVE
HAMILTON NJ
08610-3904
US

V. Phone/Fax

Practice location:
  • Phone: 732-966-1449
  • Fax:
Mailing address:
  • Phone: 732-966-1449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberTLRN063259
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: