Individual
GWENEVERE JENRETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
321 E 9TH ST, CHESTER, PA 19013-6020
(610) 745-2431
Mailing address
321 E 9TH ST, CHESTER, PA 19013-6020
(610) 745-2431
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN094573L
PA
Other
Enumeration date
02/02/2017
Last updated
02/02/2017
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