Provider Demographics
NPI:1104862945
Name:YAKUPCIN, JENNIFER PICARD (MSN, RN, CPNP, CORLN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:PICARD
Last Name:YAKUPCIN
Suffix:
Gender:F
Credentials:MSN, RN, CPNP, CORLN
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:623 HUNTINGTON DR
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-4827
Mailing Address - Country:US
Mailing Address - Phone:610-458-1080
Mailing Address - Fax:
Practice Address - Street 1:3400 CIVIC CENTER BLVD
Practice Address - Street 2:DIVISION OF OTOLARYNGOLOGY
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5127
Practice Address - Country:US
Practice Address - Phone:215-590-3440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP008595363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics