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NPI Code Detail

MEDICARE: JENNIFER L KESTERSON CRNP

MEDICARE: JENNIFER L KESTERSON CRNP
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
1363LA2200XAdult Health Nurse PractitionerSP014083PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871645291
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER L KESTERSON CRNP
Provider Business Mailing Address
First Line : 1251 E MAIN ST
Second Line :
City : ANNVILLE
State : PA
Zip : 17003-1643
Country : US
Telephone Number : 717-867-4671
Fax Number : 717-867-4981
Provider Business Practice Location Address
First Line : 1251 E MAIN ST
Second Line :
City : ANNVILLE
State : PA
Zip : 17003-1643
Country : US
Telephone Number : 717-867-4671
Fax Number : 717-867-4981
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2007
Last Update Date : 12/10/2020

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Directions to “ JENNIFER L KESTERSON CRNP” Practice Location

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