Healthcare Provider Details

I. General information

NPI: 1922717610
Provider Name (Legal Business Name): JENNIFER HERMAN FNTP, MLBD, PMH-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2022
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5119 POCONO CREST RD
POCONO PINES PA
18350
US

IV. Provider business mailing address

5119 POCONO CREST RD
POCONO PINES PA
18350
US

V. Phone/Fax

Practice location:
  • Phone: 570-446-5575
  • Fax:
Mailing address:
  • Phone: 570-446-5575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: