MEDICARE: DR. JINCY JOHN DNP

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
1	363LP2300X	Primary Care Nurse Practitioner	SP025192	PA
2	363L00000X	Nurse Practitioner	LG-0013366	DE

General Provider Information

NPI Number	:	1477202026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JINCY JOHN DNP

Provider Business Mailing Address
First Line	:	4414 CROSLAND RD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19154-4314
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 BUSTLETON PIKE STE 9
Second Line	:
City	:	FEASTERVILLE TREVOSE
State	:	PA
Zip	:	19053-4108
Country	:	US
Telephone Number	:	215-821-6332
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2022
Last Update Date	:	02/08/2026

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