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General NPI Number Information
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NPI Number | 1972651099
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Entity Type | Individual
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Provider Name | JODIE BETH PEZZNER ANP-C
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Gender | Female
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 501 W 14TH ST
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City | WILMINGTON
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State | DE
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Zip | 19801-1013
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Country | US
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Telephone | 302-428-4251
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Fax | 302-428-4280
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Provider Business Mailing Address
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Address Line | 1513 BROAD RUN RD
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City | LANDENBERG
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State | PA
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Zip | 19350-1330
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Country | US
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Telephone | 610-274-8098
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Fax | 302-428-4280
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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 | LB0000103
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License Number State | DE
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