Provider Demographics
NPI:1831409226
Name:ZIPAY, JACQUELINE L (CRNP)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:L
Last Name:ZIPAY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:L
Other - Last Name:GRAFTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:3400 CIVIC CENTER BLVD.
Mailing Address - Street 2:4TH FLOOR - PERELMAN WEST
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5127
Mailing Address - Country:US
Mailing Address - Phone:215-615-7500
Mailing Address - Fax:215-592-6588
Practice Address - Street 1:3400 CIVIC CENTER BLVD.
Practice Address - Street 2:4TH FLOOR - PERELMAN WEST
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5127
Practice Address - Country:US
Practice Address - Phone:215-615-7500
Practice Address - Fax:215-592-6588
Is Sole Proprietor?:No
Enumeration Date:2010-10-19
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010866363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PANPIOtherUNITEDHEALTHCARE
PANPIOtherBRAVO
PA30092161OtherKEYSTONE MERCY
PA36300SP010866OtherHEALTH PARTNERS
PA1025557320001Medicaid