Jennifer Anderson

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN114458 Issued in OH

Practice address

462 Township Road 1101
Nova, OH 44859-9737

Phone

(567) 217-1980

NPI assigned

Apr 24, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1461456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461456000000",
    "number": "1144675489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "462 TOWNSHIP ROAD 1101",
            "city": "NOVA",
            "state": "OH",
            "postal_code": "448599737",
            "telephone_number": "567-217-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 TOWNSHIP ROAD 1101",
            "city": "NOVA",
            "state": "OH",
            "postal_code": "448599737",
            "telephone_number": "567-217-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-24",
        "last_updated": "2016-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN114458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cindy Brooky I
• Amy Clark
• Erie Shores Rehabilitation, LLC
• Cathy Louise Frombaugh, LPTA
• Jacquelyne Beth Gifford, LPN

• Licensed Practical Nurse in Nova, OH
• Providers in Nova, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.