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NPI Code Detail

MEDICARE: MRS. JENNIFER JONES WHITLEY FNP

MEDICARE: MRS. JENNIFER JONES WHITLEY FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner201765NC

General Provider Information

NPI Number : 1295797108
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER JONES WHITLEY FNP
Provider Business Mailing Address
First Line : 725 POLLARD RD
Second Line :
City : SMITHFIELD
State : NC
Zip : 27577-9084
Country : US
Telephone Number : 919-989-6971
Fax Number :
Provider Business Practice Location Address
First Line : 3333 NC HIGHWAY 242 N
Second Line :
City : BENSON
State : NC
Zip : 27504-7844
Country : US
Telephone Number : 919-894-2911
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2006
Last Update Date : 07/08/2007

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