Provider Demographics
NPI:1922859586
Name:DZERA, JENNIFER (MS CAM, BD, CPD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:DZERA
Suffix:
Gender:F
Credentials:MS CAM, BD, CPD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10988 WILLIAMSON RD
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-8698
Mailing Address - Country:US
Mailing Address - Phone:814-373-8190
Mailing Address - Fax:
Practice Address - Street 1:2200 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:FARRELL
Practice Address - State:PA
Practice Address - Zip Code:16121-1357
Practice Address - Country:US
Practice Address - Phone:814-373-8190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula