Provider Demographics
NPI:1033699962
Name:SCHAEFER, JENNIFER SARA LOUISE (CRNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SARA LOUISE
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:CRNP
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Other - Credentials:
Mailing Address - Street 1:119 VIP DR STE 102
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-7976
Mailing Address - Country:US
Mailing Address - Phone:724-935-2610
Mailing Address - Fax:724-935-0331
Practice Address - Street 1:SEWICKLEY VALLEY PEDIATRIC AND ADOLESCENT MEDICINE, PC
Practice Address - Street 2:701 BROAD STREET, SUITE 422
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1652
Practice Address - Country:US
Practice Address - Phone:412-741-8700
Practice Address - Fax:712-741-3710
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP019009363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily