Provider Demographics
NPI:1598156879
Name:UBBENS, JENNIFER LOUISE (CRNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LOUISE
Last Name:UBBENS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1766 WILMINGTON PIKE
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1378
Mailing Address - Country:US
Mailing Address - Phone:610-358-2778
Mailing Address - Fax:610-358-3508
Practice Address - Street 1:1766 WILMINGTON PIKE
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1378
Practice Address - Country:US
Practice Address - Phone:610-358-2778
Practice Address - Fax:610-358-3508
Is Sole Proprietor?:No
Enumeration Date:2015-02-09
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014465363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner