Provider Demographics
NPI:1548235716
Name:AMMONS, JENNIFER S (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:S
Last Name:AMMONS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:160 NORTH POINT BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601
Mailing Address - Country:US
Mailing Address - Phone:717-569-6481
Mailing Address - Fax:717-569-5213
Practice Address - Street 1:160 NORTH POINT BOULEVARD
Practice Address - Street 2:SUITE 110
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601
Practice Address - Country:US
Practice Address - Phone:717-569-6481
Practice Address - Fax:717-569-5213
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD073304L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA20027799OtherAMERIHEALTH MERCY HEALTH
PA3568634OtherAETNA HMO
PA7941403OtherAETNA NON-HMO
PAP002592OtherGATEWAY HEALTH PLAN
PA81127 S1BXOtherGEISINGER HEALTH PLAN
PA50015642OtherCAPITAL BLUE CROSS
PA0018412620004Medicaid
PA964196OtherHIGHMARK BLUE SHIELD
PAP002592OtherHEALTH ASSURANCE
PA81127 S1BXOtherGEISINGER HEALTH PLAN