Individual
MS. JELENA DINIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
17TH & CHEW ST, ALLENTOWN, PA 18102
(610) 402-9099
(610) 402-9029
Mailing address
1245 S CEDAR CREST BLVD, SUITE 301, ALLENTOWN, PA 18103-6258
(610) 402-9099
(610) 402-9029
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN247091L
PA
363LF0000X
Family Nurse Practitioner
Primary
VP006565B
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03211501
CAPITAL ADVANTAGE
PA
01
—
1389298
KEYSTONE CENTRAL
PA
Enumeration date
09/07/2005
Last updated
11/14/2011
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