Basic Information
| Provider Information | |||||||||
| NPI: | 1124612189 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZAGER | ||||||||
| FirstName: | JENNA | ||||||||
| MiddleName: | NICOLE | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 602 CARRIE DR | ||||||||
| Address2: | |||||||||
| City: | DALLASTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173139254 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7176549493 | ||||||||
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| Practice Location | |||||||||
| Address1: | 20 NORTH ST | ||||||||
| Address2: | |||||||||
| City: | HANOVER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173312275 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7176377755 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2021 | ||||||||
| LastUpdateDate: | 07/19/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | MA062178 | PA | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | OA005591 | PA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.