MEDICARE: JENNIFER LU N.P.

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	163W00000X	Registered Nurse	687104	NY
2	163W00000X	Registered Nurse	95064407	CA
3	363LF0000X	Family Nurse Practitioner	95004162	CA

General Provider Information

NPI Number	:	1750764940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LU N.P.

Provider Business Mailing Address
First Line	:	700 25TH AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94121-3612
Country	:	US
Telephone Number	:	408-504-4070
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 25TH AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94121-3612
Country	:	US
Telephone Number	:	408-504-4070
Fax Number	:

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

Provider Enumeration Date	:	07/07/2015
Last Update Date	:	04/19/2016

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