Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Jacob Burnell Penhollow, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1285453936

Mr. Jacob Burnell Penhollow, FNP-BC is a Nurse Practitioner in Bradford, Pennsylvania. Qualified in 2022, 4 years ago. Practices with Delphi Healthcare PLLC, a 64-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New York.

Years since qualifying
4
Licensed in
NY
In the registry since
2024
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

116 Interstate Pkwy
Bradford, PA 16701-1036
Phone: (814) 362-8274
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 515 Main St, Olean, NY 14760-1598 — (716) 373-2600

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 351530 (NY)

Record details

NPI number1285453936
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-BC
Sole proprietorNo
NPI enumeratedOctober 9, 2024
Last updated in NPPESOctober 9, 2024
Certification dateOctober 9, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Delphi Healthcare Pllc — 64 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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