Provider Demographics
NPI:1417680315
Name:SPARLING, JENNY (CRNP, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:SPARLING
Suffix:
Gender:F
Credentials:CRNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 MUD CREEK RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:PA
Mailing Address - Zip Code:16947-9529
Mailing Address - Country:US
Mailing Address - Phone:570-297-3746
Mailing Address - Fax:
Practice Address - Street 1:45 MUD CREEK RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:PA
Practice Address - Zip Code:16947-9529
Practice Address - Country:US
Practice Address - Phone:570-297-3746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-07
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN657375163W00000X
PASP025908363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse