Provider Demographics
NPI:1538540778
Name:HOLDEN, JEAN MARIE (MSN APN FNP-BC)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:MARIE
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:MSN APN FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 223
Mailing Address - Street 2:8 W 4TH ST
Mailing Address - City:BARNEGAT LIGHT
Mailing Address - State:NJ
Mailing Address - Zip Code:08006-0223
Mailing Address - Country:US
Mailing Address - Phone:609-226-8532
Mailing Address - Fax:
Practice Address - Street 1:8 W 4TH ST
Practice Address - Street 2:
Practice Address - City:BARNEGAT LIGHT
Practice Address - State:NJ
Practice Address - Zip Code:08006-1439
Practice Address - Country:US
Practice Address - Phone:609-226-8532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-13
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00572800363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner