Provider Demographics
NPI:1033683479
Name:CINQMARS, JENNIFER MANDY (RN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MANDY
Last Name:CINQMARS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:JENNIFER
Other - Middle Name:MANDY
Other - Last Name:CINQMARS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN BSN
Mailing Address - Street 1:905 W GOVERNOR RD STE 300
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-2307
Mailing Address - Country:US
Mailing Address - Phone:717-531-7561
Mailing Address - Fax:
Practice Address - Street 1:905 W GOVERNOR RD STE 300
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2307
Practice Address - Country:US
Practice Address - Phone:717-531-7561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN518709L163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator