Provider Demographics
NPI:1144087032
Name:MCGONNELL, JENNIFER (MSN, CRNP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:MCGONNELL
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:814-353-1030
Mailing Address - Fax:814-353-1053
Practice Address - Street 1:226 BUCKAROO LANE
Practice Address - Street 2:
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-9120
Practice Address - Country:US
Practice Address - Phone:814-353-1030
Practice Address - Fax:814-353-1053
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-06
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMM8900880363L00000X
PASP032088363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner