Provider Demographics
NPI:1578526547
Name:ABERNATHY-LENOWITZ, JESSICA MARKEL (NP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARKEL
Last Name:ABERNATHY-LENOWITZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37314 HIDDEN HAVEN CV
Mailing Address - Street 2:
Mailing Address - City:SELBYVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19975-3813
Mailing Address - Country:US
Mailing Address - Phone:410-459-6691
Mailing Address - Fax:
Practice Address - Street 1:37314 HIDDEN HAVEN CV
Practice Address - Street 2:
Practice Address - City:SELBYVILLE
Practice Address - State:DE
Practice Address - Zip Code:19975-3813
Practice Address - Country:US
Practice Address - Phone:410-459-6691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT11481363LF0000X
AL3-000119363LF0000X, 363LW0102X
DCRN1060364363LF0000X
VA24164002363LF0000X
FLAPRN11017357363LF0000X
AZ233822363LF0000X
COC-APN.0002442C-NP363LP0808X
COC-APN.0002442-C-NP363LP0808X
DEL8-0010415363LP0808X
TX1035815363LW0102X
MDR138381363LW0102X
CA95020531363LW0102X
MDAC005121363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP72907Medicare UPIN