Healthcare Provider Details

I. General information

NPI: 1528653706
Provider Name (Legal Business Name): JOLIE SINCLAIR JEMMOTT RN, CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2021
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 CHESTNUT ST
PHILADELPHIA PA
19139-3205
US

IV. Provider business mailing address

5501 CHESTNUT ST
PHILADELPHIA PA
19139-3205
US

V. Phone/Fax

Practice location:
  • Phone: 215-748-8400
  • Fax: 215-748-8871
Mailing address:
  • Phone: 215-748-8400
  • Fax: 215-748-8871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN723844
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP027064
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: