Provider Demographics
NPI:1720254824
Name:MCELVEEN, JENNIFER (CRNP:)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MCELVEEN
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 1:5430 NW 33RD AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-6349
Mailing Address - Country:US
Mailing Address - Phone:877-868-4827
Mailing Address - Fax:877-283-0663
Practice Address - Street 1:1787 SENTRY PKWY W BLDG 16
Practice Address - Street 2:SUITE 405
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-2239
Practice Address - Country:US
Practice Address - Phone:215-283-6773
Practice Address - Fax:877-868-4827
Is Sole Proprietor?:No
Enumeration Date:2008-05-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009373363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health