Provider Demographics
NPI:1447736897
Name:HARPER, JENNIFER (LVN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:HARPER
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 CENTURY PARK E FL 24
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-2302
Mailing Address - Country:US
Mailing Address - Phone:888-219-5299
Mailing Address - Fax:
Practice Address - Street 1:1259 N WILLET CIR
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-2426
Practice Address - Country:US
Practice Address - Phone:888-219-5299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-18
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN243247164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse