Provider Demographics
NPI:1578446647
Name:KERNAN, JEANETTE GLORIA (APRN)
Entity type:Individual
Prefix:
First Name:JEANETTE
Middle Name:GLORIA
Last Name:KERNAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JEANETTE
Other - Middle Name:GLORIA
Other - Last Name:PANUNTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:333 ROCKLAND DR
Mailing Address - Street 2:
Mailing Address - City:CAMDEN WYOMING
Mailing Address - State:DE
Mailing Address - Zip Code:19934-3682
Mailing Address - Country:US
Mailing Address - Phone:302-883-4936
Mailing Address - Fax:
Practice Address - Street 1:333 ROCKLAND DR
Practice Address - Street 2:
Practice Address - City:CAMDEN WYOMING
Practice Address - State:DE
Practice Address - Zip Code:19934-3682
Practice Address - Country:US
Practice Address - Phone:302-883-4936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELI-0000118364SC1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public Health