Healthcare Provider Details

I. General information

NPI: 1205961760
Provider Name (Legal Business Name): FRANCES JEBLEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

749 SPRINGDALE DR
EXTON PA
19341-2829
US

IV. Provider business mailing address

749 SPRINGDALE DR
EXTON PA
19341-2829
US

V. Phone/Fax

Practice location:
  • Phone: 610-524-5850
  • Fax: 610-524-5855
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-001210-E
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0019331770001
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: