1023064169 NPI number — MRS. JENNIFER M SIEGLE RN, CPNP

Table of content: MRS. JENNIFER M SIEGLE RN, CPNP (NPI 1023064169)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023064169 NPI number — MRS. JENNIFER M SIEGLE RN, CPNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SIEGLE
Provider First Name:
JENNIFER
Provider Middle Name:
M
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN, CPNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023064169
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/23/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
159 PORTSMOUTH CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLEN MILLS
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19342-2601
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-590-4075
Provider Business Mailing Address Fax Number:
215-590-9045

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3400 CIVIC CENTER BLVD
Provider Second Line Business Practice Location Address:
5TH FLOOR WOOD BUILDING
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19104-4306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-590-4075
Provider Business Practice Location Address Fax Number:
215-590-9045
Provider Enumeration Date:
05/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0200X , with the licence number:  RN-517973-L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com