Provider Demographics
NPI:1568938991
Name:METZGER, JENNIFER M (PA-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:METZGER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-6130
Mailing Address - Country:US
Mailing Address - Phone:856-362-1806
Mailing Address - Fax:609-267-9457
Practice Address - Street 1:800 SPRUCE STREET
Practice Address - Street 2:1 CATHCART
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-6130
Practice Address - Country:US
Practice Address - Phone:856-362-1806
Practice Address - Fax:609-267-9457
Is Sole Proprietor?:No
Enumeration Date:2018-10-24
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00499100363AS0400X
PAMA061769363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical