Healthcare Provider Details

I. General information

NPI: 1871807511
Provider Name (Legal Business Name): JENNIFER CEGLIA CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2010
Last Update Date: 01/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1361 E BOOT RD
WEST CHESTER PA
19380-5934
US

IV. Provider business mailing address

1361 E BOOT RD
WEST CHESTER PA
19380-5934
US

V. Phone/Fax

Practice location:
  • Phone: 484-653-1416
  • Fax:
Mailing address:
  • Phone: 484-653-1416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License NumberSP008388
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: