Individual
JENNIFER L RAYNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
34TH STREET & CIVIC CENTER BOULEVARD, SUITE 9329, PHILADELPHIA, PA 19104-4399
(215) 590-1858
(215) 590-1415
Mailing address
100 E PENN SQ, THE WANAMAKER BUILDING, 9TH FLOOR, PHILADELPHIA, PA 19107-3323
(267) 425-9300
(267) 425-9331
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
26NR13159900
NJ
367500000X
Certified Registered Nurse Anesthetist
L1-0035310
DE
367500000X
Certified Registered Nurse Anesthetist
Primary
RN502885L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
189272EJL
MEDICARE PTAN
PA
Enumeration date
06/11/2009
Last updated
04/10/2013
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