Provider Demographics
NPI:1972835833
Name:WILLIAMS, JENNIFER ANGELA (CRNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANGELA
Last Name:WILLIAMS
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 1:136 BUTTERNUT DR
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-1573
Mailing Address - Country:US
Mailing Address - Phone:610-327-1562
Mailing Address - Fax:
Practice Address - Street 1:101 EAST STATE STREET
Practice Address - Street 2:GENESIS PHYSICIAN SERVICES
Practice Address - City:KENNETH SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348
Practice Address - Country:US
Practice Address - Phone:610-925-2029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-03
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN600369163W00000X
PASP013439363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse