Provider Demographics
NPI:1760375174
Name:NITZSCHE, JENNIFER ANNE (LPN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANNE
Last Name:NITZSCHE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 ACCIDENT BITTINGER RD
Mailing Address - Street 2:
Mailing Address - City:ACCIDENT
Mailing Address - State:MD
Mailing Address - Zip Code:21520-1312
Mailing Address - Country:US
Mailing Address - Phone:410-262-8784
Mailing Address - Fax:
Practice Address - Street 1:112 ACCIDENT BITTINGER RD
Practice Address - Street 2:
Practice Address - City:ACCIDENT
Practice Address - State:MD
Practice Address - Zip Code:21520-1312
Practice Address - Country:US
Practice Address - Phone:410-262-8784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLP48168164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse