Provider Demographics
NPI:1336629435
Name:HERSHBERGER, JAN MARIE (FNP-CRNP)
Entity Type:Individual
Prefix:
First Name:JAN
Middle Name:MARIE
Last Name:HERSHBERGER
Suffix:
Gender:F
Credentials:FNP-CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 HOMEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:PA
Mailing Address - Zip Code:17268-1620
Mailing Address - Country:US
Mailing Address - Phone:717-404-4275
Mailing Address - Fax:
Practice Address - Street 1:1000 NORLAND AVE
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-4229
Practice Address - Country:US
Practice Address - Phone:717-267-6363
Practice Address - Fax:717-839-6421
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN616401163W00000X
PASP019176363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103566740Medicaid
14253492OtherCAQH