Provider Demographics
NPI:1366503724
Name:EHREN, JOCELYN C (NP)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:C
Last Name:EHREN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JOCELYN
Other - Middle Name:
Other - Last Name:CABAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-6110
Mailing Address - Fax:717-851-1999
Practice Address - Street 1:1601 S QUEEN ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-4630
Practice Address - Country:US
Practice Address - Phone:717-851-6110
Practice Address - Fax:717-851-1999
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015095363LA2200X
WI200400254363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA456694FLTMedicare PIN