Provider Demographics
NPI:1962276691
Name:JENNIFER L GINDT ARNP-C
Entity type:Organization
Organization Name:JENNIFER L GINDT ARNP-C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:GINDT
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:719-494-7027
Mailing Address - Street 1:51 CHICKADEE LN
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-9611
Mailing Address - Country:US
Mailing Address - Phone:719-494-7027
Mailing Address - Fax:
Practice Address - Street 1:1410 LAKESIDE CT STE 107
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-7305
Practice Address - Country:US
Practice Address - Phone:719-494-7027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:605299766
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty