Provider Demographics
NPI:1003216557
Name:PANNING, JENNIFER M
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:M
Last Name:PANNING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:M
Other - Last Name:SHEMANSKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP- C
Mailing Address - Street 1:100 WILSON RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-7885
Mailing Address - Country:US
Mailing Address - Phone:831-649-1000
Mailing Address - Fax:
Practice Address - Street 1:2 UPPER RAGSDALE DR BLDG A
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5736
Practice Address - Country:US
Practice Address - Phone:831-333-3040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-02
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95021776363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner