Healthcare Provider Details
I. General information
NPI: 1316932312
Provider Name (Legal Business Name): JENNIFER MURRAY AEBLI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/15/2005
Last Update Date: 10/04/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5 MORGAN HWY STE 4
SCRANTON PA
18508-2641
US
IV. Provider business mailing address
5 MORGAN HWY STE 4
SCRANTON PA
18508-2641
US
V. Phone/Fax
- Phone: 570-344-3788
- Fax:
- Phone: 570-344-3788
- Fax: 570-929-9280
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | MA-001952-L |
| License Number State | PA |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: