Provider Demographics
NPI:1346964392
Name:CAPE, JENNIFER (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:CAPE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 TALBOT STREET
Mailing Address - Street 2:1808
Mailing Address - City:LONDON
Mailing Address - State:ON
Mailing Address - Zip Code:N6A 2S6
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:268 GROSVENOR STREET
Practice Address - Street 2:OOM D1-203A
Practice Address - City:LONDON
Practice Address - State:ONTARIO
Practice Address - Zip Code:N6A 4V2
Practice Address - Country:CA
Practice Address - Phone:519-646-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ1185162086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery