Provider Demographics
NPI:1164938015
Name:JACOBSON, JENNA ELIZABETH (MSN, RN, CPNP-AC)
Entity Type:Individual
Prefix:MRS
First Name:JENNA
Middle Name:ELIZABETH
Last Name:JACOBSON
Suffix:
Gender:F
Credentials:MSN, RN, CPNP-AC
Other - Prefix:MISS
Other - First Name:JENNA
Other - Middle Name:ELIZABETH
Other - Last Name:DEANGELIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:675 WHITE ASH DR
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-8026
Mailing Address - Country:US
Mailing Address - Phone:215-630-9122
Mailing Address - Fax:
Practice Address - Street 1:3401 CIVIC CENTER BLVD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4319
Practice Address - Country:US
Practice Address - Phone:215-590-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-14
Last Update Date:2022-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018348363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics