Provider Demographics
NPI:1316239858
Name:TOWNSEND, JENNA ELISABETH (PA-C, MHS)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:ELISABETH
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:PA-C, MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 SHERWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-9506
Mailing Address - Country:US
Mailing Address - Phone:609-287-4421
Mailing Address - Fax:
Practice Address - Street 1:517 SHERWOOD RD
Practice Address - Street 2:
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-9506
Practice Address - Country:US
Practice Address - Phone:609-287-4421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00254900363A00000X
PAMA054851363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant