Healthcare Provider Details

I. General information

NPI: 1356096531
Provider Name (Legal Business Name): JENNIFER MARIE LOCONSOLE CRNP, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER MARIE SENSKE RN

II. Dates (important events)

Enumeration Date: 02/16/2022
Last Update Date: 02/16/2022
Certification Date: 02/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 ROCKLAND RD
WILMINGTON DE
19803-3607
US

IV. Provider business mailing address

112 W 11TH AVE
CONSHOHOCKEN PA
19428-1418
US

V. Phone/Fax

Practice location:
  • Phone: 302-298-8400
  • Fax:
Mailing address:
  • Phone: 215-290-0410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN651476
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberSP023946
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberL1-0049163
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: