Provider Demographics
NPI:1841663945
Name:AUSTIN, JENNIFER ELISABETH (APRN, CPNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ELISABETH
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:APRN, CPNP
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:751 E 36TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-4166
Mailing Address - Country:US
Mailing Address - Phone:907-222-5090
Mailing Address - Fax:907-222-5093
Practice Address - Street 1:751 E 36TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503
Practice Address - Country:US
Practice Address - Phone:907-222-5090
Practice Address - Fax:907-222-5093
Is Sole Proprietor?:No
Enumeration Date:2015-11-11
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT13850363LP0200X
CA95025289363LP0200X
NY172260363LP0200X
AK113174363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics