Healthcare Provider Details

I. General information

NPI: 1992828990
Provider Name (Legal Business Name): JENNIFER ELAINE HUFNAGLE CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER ELAINE MORRIS CNA

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1259 MARKET STREET
SUNBURY PA
17801
US

IV. Provider business mailing address

1259 MARKET ST
SUNBURY PA
17801-2420
US

V. Phone/Fax

Practice location:
  • Phone: 570-524-0900
  • Fax: 570-524-0910
Mailing address:
  • Phone: 570-286-7607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number9203450
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: