Provider Demographics
NPI:1023064169
Name:SIEGLE, JENNIFER M (RN, CPNP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:M
Last Name:SIEGLE
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Gender:F
Credentials:RN, CPNP
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Mailing Address - Street 1:159 PORTSMOUTH CIR
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-2601
Mailing Address - Country:US
Mailing Address - Phone:215-590-4075
Mailing Address - Fax:215-590-9045
Practice Address - Street 1:3400 CIVIC CENTER BLVD
Practice Address - Street 2:5TH FLOOR WOOD BUILDING
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4306
Practice Address - Country:US
Practice Address - Phone:215-590-4075
Practice Address - Fax:215-590-9045
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2007-07-23
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Provider Licenses
StateLicense IDTaxonomies
PARN-517973-L363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics