Provider Demographics
NPI:1700101938
Name:FIRLEIN, JENNETTE A (APN)
Entity Type:Individual
Prefix:MRS
First Name:JENNETTE
Middle Name:A
Last Name:FIRLEIN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MS
Other - First Name:JENNETTE
Other - Middle Name:A
Other - Last Name:WIKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:PO BOX 191
Mailing Address - Street 2:PROVIDER ENROLLMENT
Mailing Address - City:ROCKLAND
Mailing Address - State:DE
Mailing Address - Zip Code:19732-0191
Mailing Address - Country:US
Mailing Address - Phone:302-651-6212
Mailing Address - Fax:302-651-4945
Practice Address - Street 1:1600 ROCKLAND RD
Practice Address - Street 2:NEMOURS CHILDRENS CLINIC
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3607
Practice Address - Country:US
Practice Address - Phone:302-651-5600
Practice Address - Fax:302-651-5612
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELJ-0000255163WR0400X
DEL10034230363L00000X
DELJ0000255363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner