Provider Demographics
NPI:1578377966
Name:COLON, JENNIFER N (LPN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:N
Last Name:COLON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8015 155TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-1756
Mailing Address - Country:US
Mailing Address - Phone:917-968-4868
Mailing Address - Fax:
Practice Address - Street 1:8015 155TH AVE FL 1
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-1756
Practice Address - Country:US
Practice Address - Phone:917-968-4868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY346190251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care