Provider Demographics
NPI:1326682311
Name:DAVOLI, JENNIFER L (APN, AGACNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:L
Last Name:DAVOLI
Suffix:
Gender:F
Credentials:APN, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 ENLOW PL
Mailing Address - Street 2:
Mailing Address - City:PENNSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08070-2003
Mailing Address - Country:US
Mailing Address - Phone:856-230-5601
Mailing Address - Fax:
Practice Address - Street 1:310 SALEM WOODSTOWN RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NJ
Practice Address - Zip Code:08079-2064
Practice Address - Country:US
Practice Address - Phone:856-935-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-01
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP025547363LA2100X
TNAPN0000032508363LA2100X
NJ26NJ00957300363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care