Provider Demographics
NPI:1386130938
Name:SPIGNESE, JENNIFER LYNN (FNP-C, MSN, RN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:SPIGNESE
Suffix:
Gender:F
Credentials:FNP-C, MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26800 CROWN VALLEY PKWY STE 305
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-8017
Mailing Address - Country:US
Mailing Address - Phone:949-364-6000
Mailing Address - Fax:949-364-3213
Practice Address - Street 1:26800 CROWN VALLEY PKWY STE 305
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691
Practice Address - Country:US
Practice Address - Phone:949-364-6000
Practice Address - Fax:949-364-3213
Is Sole Proprietor?:No
Enumeration Date:2018-07-06
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95008500363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANPF95008500OtherSTATE OF CALIFORNIA BRN
CANP95008500OtherSTATE OF CALIFORNIA BRN