Healthcare Provider Details

I. General information

NPI: 1679075840
Provider Name (Legal Business Name): JENNIFER KERSTETTER NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2018
Last Update Date: 07/27/2022
Certification Date: 07/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 N 21ST ST STE 101
CAMP HILL PA
17011-2223
US

IV. Provider business mailing address

2012 S TOLLGATE RD
BEL AIR MD
21015-5900
US

V. Phone/Fax

Practice location:
  • Phone: 717-972-4250
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR179185
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP021141
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberR179185
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: