Individual
JENNIE LOUISA QUEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
106 S BROAD ST, MIDDLETOWN, DE 19709-1439
(302) 449-1710
Mailing address
106 S BROAD ST, MIDDLETOWN, DE 19709-1439
(302) 449-1710
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C5-439
DE
Other
Enumeration date
10/24/2008
Last updated
10/24/2008
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