Provider Demographics
NPI:1730978594
Name:SIEPKA, JENNY LYNNE (RN)
Entity type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:LYNNE
Last Name:SIEPKA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 W SOUTH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-5039
Mailing Address - Country:US
Mailing Address - Phone:540-217-2831
Mailing Address - Fax:
Practice Address - Street 1:108 W SOUTH ST STE 101
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-5039
Practice Address - Country:US
Practice Address - Phone:540-217-2831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001265970163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse