Provider Demographics
NPI:1629843255
Name:DOWE, JENNIFER JACQUELINE (RN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JACQUELINE
Last Name:DOWE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:JACQUELINE
Other - Last Name:SMART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2322 16TH ST SE APT 1
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-4316
Mailing Address - Country:US
Mailing Address - Phone:202-735-6008
Mailing Address - Fax:
Practice Address - Street 1:1901 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:CROYDON
Practice Address - State:PA
Practice Address - Zip Code:19021-6876
Practice Address - Country:US
Practice Address - Phone:267-987-8656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN699199163WC1500X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Single Specialty