Provider Demographics
NPI:1356305858
Name:KREBS, JESSICA DOREEN (MD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:DOREEN
Last Name:KREBS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:694 GOOD DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2433
Mailing Address - Country:US
Mailing Address - Phone:717-544-3788
Mailing Address - Fax:717-544-3789
Practice Address - Street 1:694 GOOD DR
Practice Address - Street 2:SUITE 203
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2433
Practice Address - Country:US
Practice Address - Phone:717-544-3788
Practice Address - Fax:717-544-3789
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD064978L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA053970QAAMedicare ID - Type Unspecified
PA053970QAAMedicare PIN
PAG93614Medicare UPIN