Provider Demographics
NPI:1558245548
Name:CABBAGESTALK, JESSICA T
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:T
Last Name:CABBAGESTALK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:T
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:27 BARNWELL LN
Mailing Address - Street 2:
Mailing Address - City:WILLINGBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08046-1657
Mailing Address - Country:US
Mailing Address - Phone:640-248-9112
Mailing Address - Fax:
Practice Address - Street 1:27 BARNWELL LN
Practice Address - Street 2:
Practice Address - City:WILLINGBORO
Practice Address - State:NJ
Practice Address - Zip Code:08046-1657
Practice Address - Country:US
Practice Address - Phone:640-248-9112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-02
Last Update Date:2025-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion