Provider Demographics
NPI:1942807524
Name:IRIZARRY, JAZMINE (CRNP)
Entity Type:Individual
Prefix:
First Name:JAZMINE
Middle Name:
Last Name:IRIZARRY
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 1:218 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18102-3508
Mailing Address - Country:US
Mailing Address - Phone:610-841-8400
Mailing Address - Fax:610-841-8401
Practice Address - Street 1:218 N 2ND ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-3508
Practice Address - Country:US
Practice Address - Phone:610-841-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022514363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care