Provider Demographics
NPI:1538784343
Name:DELORENZO, JENNY ANNE (RN, AGNP)
Entity type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:ANNE
Last Name:DELORENZO
Suffix:
Gender:F
Credentials:RN, AGNP
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:ANNE
Other - Last Name:SPIGNOLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:78 LOCUST DR
Mailing Address - Street 2:
Mailing Address - City:KINGS PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11754-2225
Mailing Address - Country:US
Mailing Address - Phone:631-687-0166
Mailing Address - Fax:
Practice Address - Street 1:78 LOCUST DR
Practice Address - Street 2:
Practice Address - City:KINGS PARK
Practice Address - State:NY
Practice Address - Zip Code:11754-2225
Practice Address - Country:US
Practice Address - Phone:631-687-0166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-08
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY686831-1163W00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse