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General NPI Number Information
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NPI Number | 1407847429
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Entity Type | Individual
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Provider Name | JENNIFER MARY SPELLMAN CRNP
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Gender | Female
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Dates
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Enumeration Date | 10/31/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 34TH & CIVIC CENTER BLVD
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City | PHILADELPHIA
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State | PA
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Zip | 19104
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Country | US
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Telephone | 215-590-3440
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Fax | 215-590-3986
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Provider Business Mailing Address
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Address Line | 418 SYLVAN LN
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City | DEVON
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State | PA
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Zip | 19333-1532
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Country | US
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Telephone | 610-995-0503
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | RN-275090-L
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License Number State | PA
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