Provider Demographics
NPI:1093071623
Name:NOBLE, JENNIFER REBECCA (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:REBECCA
Last Name:NOBLE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:4201 ST. ANTOINE UHC 5D MAILBOX #226
Mailing Address - Street 2:UNIVERSITY PEDIATRICIANS
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2119
Mailing Address - Country:US
Mailing Address - Phone:313-966-5051
Mailing Address - Fax:313-966-0665
Practice Address - Street 1:3901 BEAUBIEN ER - DEPT
Practice Address - Street 2:CHILDREN'S HOSPITAL OF MI
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-745-0113
Practice Address - Fax:313-993-7166
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2016-03-09
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Provider Licenses
StateLicense IDTaxonomies
MI4301106998208000000X, 2080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine