Provider Demographics
NPI:1992147888
Name:ERVIN, JENNIFER E (ACNP-BC, MSN, RN)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:E
Last Name:ERVIN
Suffix:
Gender:F
Credentials:ACNP-BC, MSN, RN
Other - Prefix:
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Mailing Address - Street 1:225 E 5TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48502-1641
Mailing Address - Country:US
Mailing Address - Phone:810-406-4912
Mailing Address - Fax:810-424-6029
Practice Address - Street 1:G3375 S SAGINAW ST
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48529-1277
Practice Address - Country:US
Practice Address - Phone:810-743-6830
Practice Address - Fax:810-743-7086
Is Sole Proprietor?:No
Enumeration Date:2013-07-22
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704264222363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care