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NPI Code Detail

MEDICARE: JENNIFER FOLEY NP

MEDICARE: JENNIFER FOLEY NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse28161601AIN
2363LG0600XGerontology Nurse Practitioner71005163AIN
3363L00000XNurse Practitioner71005163AIN

General Provider Information

NPI Number : 1164831509
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER FOLEY NP
Provider Business Mailing Address
First Line : 7972 W JEFFERSON BLVD
Second Line : STE A
City : FORT WAYNE
State : IN
Zip : 46804-4140
Country : US
Telephone Number : 260-459-1780
Fax Number : 260-459-2779
Provider Business Practice Location Address
First Line : 7972 W JEFFERSON BLVD
Second Line : STE A
City : FORT WAYNE
State : IN
Zip : 46804-4140
Country : US
Telephone Number : 260-459-1780
Fax Number : 260-459-2779
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2014
Last Update Date : 10/06/2014

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