Provider Demographics
NPI:1063989747
Name:MARKS, JENNIFER LE (CRNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LE
Last Name:MARKS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:454 CHESTNUT WAY
Mailing Address - Street 2:
Mailing Address - City:NEW CUMBERLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17070-2733
Mailing Address - Country:US
Mailing Address - Phone:267-664-1197
Mailing Address - Fax:
Practice Address - Street 1:2140 FISHER RD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-5122
Practice Address - Country:US
Practice Address - Phone:717-766-1795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-31
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASPO19420363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily