Provider Demographics
NPI:1043552383
Name:VENAFRA, JENNIFER MARY (CRNA)
Entity Type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:MARY
Last Name:VENAFRA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 WOODSTONE DR
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-7014
Mailing Address - Country:US
Mailing Address - Phone:215-771-3803
Mailing Address - Fax:
Practice Address - Street 1:16 WOODSTONE DR
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-7014
Practice Address - Country:US
Practice Address - Phone:215-771-3803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-25
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN576905163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse