Provider Demographics
NPI:1174599963
Name:PIPER, JENEPHER (CRNP)
Entity type:Individual
Prefix:MS
First Name:JENEPHER
Middle Name:
Last Name:PIPER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11121 YORK RD
Mailing Address - Street 2:
Mailing Address - City:COCKEYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21030-2006
Mailing Address - Country:US
Mailing Address - Phone:410-628-2026
Mailing Address - Fax:410-667-6834
Practice Address - Street 1:11121 YORK RD
Practice Address - Street 2:
Practice Address - City:HUNT VALLEY
Practice Address - State:MD
Practice Address - Zip Code:21030-2006
Practice Address - Country:US
Practice Address - Phone:410-628-2026
Practice Address - Fax:410-667-6834
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR127534207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD005M677EMedicare ID - Type Unspecified
MDP29425Medicare UPIN