Provider Demographics
NPI:1619369378
Name:ENTREKIN, JENNIFER B (APN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:B
Last Name:ENTREKIN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:K
Other - Last Name:BIEHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:4755 OGLETOWN STANTON RD STE 1070
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19718-2200
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4755 OGLETOWN STANTON RD STE 1070
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718-2200
Practice Address - Country:US
Practice Address - Phone:302-733-1663
Practice Address - Fax:302-733-1616
Is Sole Proprietor?:No
Enumeration Date:2015-03-04
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0042328163W00000X
DELP-0000129363L00000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner