Provider Demographics
NPI:1609354000
Name:BISSEY, JENNIFER MARGARET (CRNA, DNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARGARET
Last Name:BISSEY
Suffix:
Gender:F
Credentials:CRNA, DNP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:MARGARET
Other - Last Name:WOELFEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1419 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-1251
Mailing Address - Country:US
Mailing Address - Phone:919-260-6036
Mailing Address - Fax:
Practice Address - Street 1:3643 N ROXBORO ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2702
Practice Address - Country:US
Practice Address - Phone:919-370-6169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251099367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered