Provider Demographics
NPI:1225465438
Name:SHOENFELT, JENNIFER ANNE (LMT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANNE
Last Name:SHOENFELT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 GREENWOOD CT
Mailing Address - Street 2:D2
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-4000
Mailing Address - Country:US
Mailing Address - Phone:717-487-5221
Mailing Address - Fax:
Practice Address - Street 1:211 GREENWOOD CT
Practice Address - Street 2:D2
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-4000
Practice Address - Country:US
Practice Address - Phone:717-487-5221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG004640171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor