Provider Demographics
NPI:1447324702
Name:DUMRAUF, JENNIFER ELLEN (RN, APN, C-CNS)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ELLEN
Last Name:DUMRAUF
Suffix:
Gender:F
Credentials:RN, APN, C-CNS
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:BECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:675 PETER JEFFERSON PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8618
Mailing Address - Country:US
Mailing Address - Phone:434-817-6900
Mailing Address - Fax:434-260-8391
Practice Address - Street 1:2050 CLAIRE CT
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-7635
Practice Address - Country:US
Practice Address - Phone:847-467-7423
Practice Address - Fax:847-556-1622
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-005025364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist