Provider Demographics
NPI:1154176543
Name:MACDONALD, JENNIFER MARIE (RN, BSN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARIE
Last Name:MACDONALD
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 OLD NORTH RD
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:DE
Mailing Address - Zip Code:19934-1237
Mailing Address - Country:US
Mailing Address - Phone:302-697-3207
Mailing Address - Fax:
Practice Address - Street 1:5 OLD NORTH RD
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:DE
Practice Address - Zip Code:19934-1237
Practice Address - Country:US
Practice Address - Phone:302-697-3207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0032093163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool