Provider Demographics
NPI:1801627849
Name:BRIENZA, JENNIFER RORTVEDT (NP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:RORTVEDT
Last Name:BRIENZA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 GEHRING DR
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-6362
Mailing Address - Country:US
Mailing Address - Phone:336-453-4853
Mailing Address - Fax:
Practice Address - Street 1:6330 QUADRANGLE DR STE 500
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-8281
Practice Address - Country:US
Practice Address - Phone:919-932-5700
Practice Address - Fax:980-422-0567
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5020640363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology