MEDICARE: JENNIFER GABRIELLE BIDEY 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
1	363LF0000X	Family Nurse Practitioner	SP018204	PA
2	363LF0000X	Family Nurse Practitioner	26NJ01275900	NJ

General Provider Information

NPI Number	:	1982111720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER GABRIELLE BIDEY CRNP

Provider Business Mailing Address
First Line	:	15 E REDMAN AVE STE 1
Second Line	:
City	:	HADDONFIELD
State	:	NJ
Zip	:	08033-2316
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 E REDMAN AVE STE 1
Second Line	:
City	:	HADDONFIELD
State	:	NJ
Zip	:	08033-2316
Country	:	US
Telephone Number	:	856-922-0025
Fax Number	:

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

Provider Enumeration Date	:	01/02/2018
Last Update Date	:	05/22/2025

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