Provider Demographics
NPI:1811338486
Name:NYMARK, JENNIFER KIRSTIN (CRNP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:KIRSTIN
Last Name:NYMARK
Suffix:
Gender:F
Credentials:CRNP
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Other - Credentials:
Mailing Address - Street 1:PO BOX 746722
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6722
Mailing Address - Country:US
Mailing Address - Phone:773-352-1515
Mailing Address - Fax:312-929-0373
Practice Address - Street 1:1200 W GODFREY AVE STE 3100
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-3323
Practice Address - Country:US
Practice Address - Phone:215-444-7469
Practice Address - Fax:215-764-6555
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2025-05-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PASP012874363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health