Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | LJ0000213 | DE |
N | 363LN0000X | Nurse Practitioner - Neonatal | LJ0000213 | DE |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | LJ0000213 | DE |
N | 363LP0200X | Nurse Practitioner - Pediatrics | LJ0000213 | DE |
NPI | 1124179809 |
---|---|
Provider Name | Ms. Jennifer A. Marriner |
First Address | Rockland, DE 19732-0191 |
Second Address | Wilmington, DE 19803-3607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 31/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
21415 | (05) | NJ |
4038673 | (05) | MD |
Q07021 | (02) |