Jennifer Ruth Bobish, CRNP

Individual provider Active NPI Nurse Practitioner · Beaver, PA

NPI 1003883166 · NPPES record last updated Oct 9, 2020

Key facts

NPI
1003883166
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
SP003716G (PA)
Practice address
350 3Rd St
Beaver, PA 15009-2261
Phone
(724) 774-3232
Fax
(724) 774-4606
NPI assigned
Mar 7, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP003716GPAMDNurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP003716G PA Yes

Addresses

Primary practice location

350 3Rd St
Beaver, PA 15009-2261

Mailing address

PO Box 155
Cheswick, PA 15024-0155
Phone (412) 826-1065

Other identifiers

IdentifierTypeStateIssuer
P00306441OtherRAILROAD MEDICARE

Other providers in Beaver, PA

All providers in Beaver, PA · Nurse Practitioner in Pennsylvania

Sources for this page

Verify at the official NPI Registry.