Provider Demographics
NPI:1952064784
Name:BINGAMAN, JENNIFER (RNFA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:BINGAMAN
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:HOVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2073 MAVENCAMP CIR
Mailing Address - Street 2:
Mailing Address - City:NORTH POLE
Mailing Address - State:AK
Mailing Address - Zip Code:99705-6574
Mailing Address - Country:US
Mailing Address - Phone:907-385-7625
Mailing Address - Fax:
Practice Address - Street 1:2073 MAVENCAMP CIR
Practice Address - Street 2:
Practice Address - City:NORTH POLE
Practice Address - State:AK
Practice Address - Zip Code:99705-6574
Practice Address - Country:US
Practice Address - Phone:907-385-7625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-19
Last Update Date:2022-04-07
Deactivation Date:2021-10-21
Deactivation Code:
Reactivation Date:2022-04-07
Provider Licenses
StateLicense IDTaxonomies
AKNURR34542163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant