Individual provider · Type 1 NPI
Jennifer Malloy, CRNP
Primary Care Nurse Practitioner · Philadelphia, PA
NPI number
1972620227
Active
Practice location
3322 N Broad St
Philadelphia, PA 19140-5185
Fax (215) 707-3644
Mailing address
2450 W Hunting Park Ave
Philadelphia, PA 19129-1302
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Social Worker | 1041C0700X | CW015068 (PA) |
| Primary Care Nurse Practitioner Primary | 363LP2300X | SP017051 (PA) |
Primary Care Nurse Practitioner: Definition to come...
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About NPI 1972620227
Jennifer Malloy, CRNP's National Provider Identifier is 1972620227, issued on Mar 23, 2007. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Philadelphia, PA. The record was last updated on Mar 28, 2018.