Provider Demographics
NPI:1982111720
Name:BIDEY, JENNIFER GABRIELLE (CRNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:GABRIELLE
Last Name:BIDEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:JONATHAN
Other - Middle Name:GABRIEL
Other - Last Name:BIDEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:80 TANNER ST
Mailing Address - Street 2:
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-2453
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:80 TANNER ST
Practice Address - Street 2:
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033-2453
Practice Address - Country:US
Practice Address - Phone:856-922-0025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-02
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01275900363LF0000X
PASP018204363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily