Provider Demographics
NPI:1942026323
Name:KANIPE, JENNIFER (RN, BSN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:KANIPE
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 BUFORD HWY APT 1311
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-7791
Mailing Address - Country:US
Mailing Address - Phone:770-403-9935
Mailing Address - Fax:
Practice Address - Street 1:500 BUFORD HWY APT 1311
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-7791
Practice Address - Country:US
Practice Address - Phone:770-403-9935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN139639163WP2201X, 163WS0121X, 163WA2000X, 163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No163WS0121XNursing Service ProvidersRegistered NursePlastic Surgery
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy