Provider Demographics
NPI:1790311587
Name:TIERNAN-PALERMO, JENNIFER JOAN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JOAN
Last Name:TIERNAN-PALERMO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 LUCAS LN APT 8
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2530
Mailing Address - Country:US
Mailing Address - Phone:267-939-0411
Mailing Address - Fax:
Practice Address - Street 1:301 N CHURCH ST STE 101
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-2498
Practice Address - Country:US
Practice Address - Phone:856-234-2101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-12
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01024200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine