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General NPI Number Information
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NPI Number | 1336038504
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Entity Type | Individual
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Provider Name | JENNIFER ELAINE KENEPP
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Gender | Female
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 610 HIGHLAND AVE
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City | LEWISTOWN
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State | PA
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Zip | 17044-1146
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Country | US
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Telephone | 717-994-1799
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Fax |
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Provider Business Mailing Address
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Address Line | 610 HIGHLAND AVE
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City | LEWISTOWN
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State | PA
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Zip | 17044-1146
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Country | US
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Telephone | 717-994-1799
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN267574
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License Number State | PA
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