Provider Demographics
NPI:1467968115
Name:NOLTE, JENNIFER (CRNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:NOLTE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 S 5TH ST STE 130
Mailing Address - Street 2:
Mailing Address - City:PERKASIE
Mailing Address - State:PA
Mailing Address - Zip Code:18944-1061
Mailing Address - Country:US
Mailing Address - Phone:215-257-8601
Mailing Address - Fax:
Practice Address - Street 1:211 TELFORD PIKE
Practice Address - Street 2:
Practice Address - City:TELFORD
Practice Address - State:PA
Practice Address - Zip Code:18969-2251
Practice Address - Country:US
Practice Address - Phone:215-723-7833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-18
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018350363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology