Healthcare Provider Details

I. General information

NPI: 1437708633
Provider Name (Legal Business Name): JENNIFER ANN KALINOWSKI CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2019
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 N MAIN AVE
SCRANTON PA
18508-1995
US

IV. Provider business mailing address

501 S WASHINGTON AVE STE 1000
SCRANTON PA
18505-3814
US

V. Phone/Fax

Practice location:
  • Phone: 570-346-8417
  • Fax: 570-230-0013
Mailing address:
  • Phone: 570-591-5159
  • Fax: 570-343-3923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP032124
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP020553
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: