Provider Demographics
NPI:1740671759
Name:IGNATOSKI, JENNIFER LEIGH
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEIGH
Last Name:IGNATOSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3775 SENNA DR NE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-9282
Mailing Address - Country:US
Mailing Address - Phone:616-866-6838
Mailing Address - Fax:616-974-6875
Practice Address - Street 1:3775 SENNA DR NE
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:MI
Practice Address - Zip Code:49341-9282
Practice Address - Country:US
Practice Address - Phone:616-866-6838
Practice Address - Fax:616-974-6875
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management