Provider Demographics
NPI:1932267564
Name:WOMELDORF-DUNN, JENNIFER LYNN (MSNED, RN, CPN, CNE)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:WOMELDORF-DUNN
Suffix:
Gender:F
Credentials:MSNED, RN, CPN, CNE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3033 E THUNDERBIRD RD APT 1094
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-5684
Mailing Address - Country:US
Mailing Address - Phone:602-471-8596
Mailing Address - Fax:
Practice Address - Street 1:3300 W CAMELBACK RD # 6-220
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85017-1097
Practice Address - Country:US
Practice Address - Phone:602-639-8295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN150227163WP0200X, 163WP0807X, 163WP0809X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult