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General NPI Number Information
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NPI Number | 1144972209
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Entity Type | Individual
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Provider Name | JENNY BETH KINNARD CRNP
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Gender | Female
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Dates
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Enumeration Date | 01/20/2022
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 1632 PINE ST
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City | PHILADELPHIA
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State | PA
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Zip | 19103-6711
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Country | US
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Telephone | 215-735-7992
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Fax |
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Provider Business Mailing Address
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Address Line | 2234 BROOKVIEW PL
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City | ELKINS PARK
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State | PA
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Zip | 19027-2804
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Country | US
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Telephone | 516-707-0472
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP025139
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | SP025139
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License Number State | PA
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