Provider Demographics
NPI:1982470290
Name:MARRERO, JESCENIA (LPN)
Entity Type:Individual
Prefix:
First Name:JESCENIA
Middle Name:
Last Name:MARRERO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:JESCENIA
Other - Middle Name:
Other - Last Name:BAEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:15 S 9TH ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-5104
Mailing Address - Country:US
Mailing Address - Phone:717-273-5992
Mailing Address - Fax:
Practice Address - Street 1:15 S 9TH ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-5104
Practice Address - Country:US
Practice Address - Phone:717-273-5992
Practice Address - Fax:717-273-5995
Is Sole Proprietor?:No
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN260803L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse