Provider Demographics
NPI:1235188749
Name:HARPER, JENNIFER LYNNE (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LYNNE
Last Name:HARPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3736 W OAKLAND PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33311-1157
Mailing Address - Country:US
Mailing Address - Phone:954-759-7599
Mailing Address - Fax:954-888-3813
Practice Address - Street 1:3736 W OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33311-1157
Practice Address - Country:US
Practice Address - Phone:954-759-7599
Practice Address - Fax:954-888-3813
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMEFL94715207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01616839Medicaid
FL276088600Medicaid