Provider Demographics
NPI:1699555755
Name:BLOT, JENNIFER FERNANDEZ (MSN FNP-C)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:FERNANDEZ
Last Name:BLOT
Suffix:
Gender:F
Credentials:MSN FNP-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:ELLEN
Other - Last Name:FERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1118 EDWARD DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-3920
Mailing Address - Country:US
Mailing Address - Phone:843-568-2263
Mailing Address - Fax:
Practice Address - Street 1:1118 EDWARD DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15227-3920
Practice Address - Country:US
Practice Address - Phone:843-568-2263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-04
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP031366363LF0000X
SC26560363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily