Basic Information
| Provider Information | |||||||||
| NPI: | 1346278397 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DELOZIER | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | LYNNE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1700 OLD GATESBURG RD STE 310 | ||||||||
| Address2: | |||||||||
| City: | STATE COLLEGE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 168032276 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8142373122 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1700 OLD GATESBURG RD STE 310 | ||||||||
| Address2: | |||||||||
| City: | STATE COLLEGE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 168032276 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8142373122 | ||||||||
| FaxNumber: | 8142374050 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2006 | ||||||||
| LastUpdateDate: | 03/20/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QA0505X | MD059697L | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine | Adult Medicine |
No ID Information.