Provider Demographics
NPI:1669871182
Name:GIVENS, JENNIFER L (DNP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:L
Last Name:GIVENS
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
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Mailing Address - Street 1:301 S CAMPBELL ST
Mailing Address - Street 2:
Mailing Address - City:BURGAW
Mailing Address - State:NC
Mailing Address - Zip Code:28425-5011
Mailing Address - Country:US
Mailing Address - Phone:910-259-6973
Mailing Address - Fax:910-259-6975
Practice Address - Street 1:4811 NC HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:MAPLE HILL
Practice Address - State:NC
Practice Address - Zip Code:28454-8153
Practice Address - Country:US
Practice Address - Phone:910-259-6444
Practice Address - Fax:910-259-6659
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC22190363LF0000X
NC224861363LF0000X
VA0024172273363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily