Provider Demographics
NPI:1366293805
Name:FLOOD, JENNA L (AGNP)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:L
Last Name:FLOOD
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 RARITAN POINTE
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08530-1811
Mailing Address - Country:US
Mailing Address - Phone:908-763-1948
Mailing Address - Fax:
Practice Address - Street 1:8 RARITAN POINTE
Practice Address - Street 2:
Practice Address - City:LAMBERTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08530-1811
Practice Address - Country:US
Practice Address - Phone:908-763-1948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15043000363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner