Provider Demographics
NPI:1083967541
Name:GUNNET, JENNIFER RAECHEAL (CRNA)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:RAECHEAL
Last Name:GUNNET
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:RAECHAEL
Other - Last Name:HOLLINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-741-8250
Mailing Address - Fax:
Practice Address - Street 1:25 MONUMENT RD STE 270
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5073
Practice Address - Country:US
Practice Address - Phone:717-741-8250
Practice Address - Fax:717-741-8289
Is Sole Proprietor?:No
Enumeration Date:2012-10-22
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN591483163W00000X, 367500000X
DEL1-0040909163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103449888Medicaid