Provider Demographics
NPI:1053511451
Name:HARBAUGH, JENNIFER LEA (LPN)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LEA
Last Name:HARBAUGH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:566 S CARLISLE ST
Mailing Address - Street 2:
Mailing Address - City:GREENCASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:17225-1591
Mailing Address - Country:US
Mailing Address - Phone:717-593-9649
Mailing Address - Fax:
Practice Address - Street 1:566 S CARLISLE ST
Practice Address - Street 2:
Practice Address - City:GREENCASTLE
Practice Address - State:PA
Practice Address - Zip Code:17225-1591
Practice Address - Country:US
Practice Address - Phone:717-593-9649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLP41290164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse