Healthcare Provider Details

I. General information

NPI: 1457065211
Provider Name (Legal Business Name): JENNA YEO FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2023
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1026 BROAD ST UNIT 18
SHREWSBURY NJ
07702-4380
US

IV. Provider business mailing address

PO BOX 8519
RED BANK NJ
07701-8519
US

V. Phone/Fax

Practice location:
  • Phone: 732-542-0002
  • Fax: 732-542-2992
Mailing address:
  • Phone: 732-460-9840
  • Fax: 732-460-9848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ14881500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: