Provider Demographics
NPI:1265797328
Name:KONOWITZ, JENNIFER EILEEN (ARNP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:EILEEN
Last Name:KONOWITZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 CALEDONIA DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32951-3902
Mailing Address - Country:US
Mailing Address - Phone:321-733-0221
Mailing Address - Fax:
Practice Address - Street 1:143 CALEDONIA DR
Practice Address - Street 2:
Practice Address - City:MELBOURNE BCH
Practice Address - State:FL
Practice Address - Zip Code:32951
Practice Address - Country:US
Practice Address - Phone:321-733-0221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9283757363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily