Basic Information
| Provider Information | |||||||||
| NPI: | 1700944816 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOHKAMP | ||||||||
| FirstName: | JENNIFER | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 30170 | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198057170 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026237150 | ||||||||
| FaxNumber: | 3206237374 | ||||||||
| Practice Location | |||||||||
| Address1: | 4735 OGLETOWN STANTON RD | ||||||||
| Address2: | MAP II, SUITES 1201 & 1205 | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197132072 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3027331980 | ||||||||
| FaxNumber: | 3027331986 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2006 | ||||||||
| LastUpdateDate: | 08/11/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | C5-0005943 | DE | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363AS0400X | C5-0005943 | DE | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
ID Information
| ID | Type | State | Issuer | Description | C5-0005943 | 01 | DE | PROFESSIONAL LICENSE | OTHER |