Jaclyn Rose Ciersezwski, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Huron, OH
NPI 1346750460 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1346750460
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APRN.CNP.021800 (OH)
- Practice address
- 3202 Lawrence Ave
Huron, OH 44839-2143 - Phone
- (419) 370-8260
- NPI assigned
- Oct 3, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Fisher-Titus Medical Care LLC
Practice addresses (Care Compare)
2114 State Route 113 E
Milan, OH 44846-9483
Phone (419) 499-7600
Hospital & facility affiliations
- Ohioans Home Healthcare, Inc
- FRMC Home Health Services
- Fisher-Titus Hospital
- Firelands Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171011000984 | OH | Practitioner - Nurse Practitioner | 6305111766 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN.CNP.021800 | OH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fisher-Titus Medical Care LLC | Current |
Accepting new patients | |
| Sandusky Wellness Center Inc | Current |
Accepting new patients | |
| Fisher-Titus Medical Center | Current | Accepting new patients | |
| Sandusky Wellness DME LLC | Past |
Accepting new patients |
Locations
2114 State Route 113 E
Milan, OH 44846
Phone (419) 499-4500
368 Milan Ave
Ste D
Norwalk, OH 44857
Phone (419) 663-6464
272 Benedict Ave
Norwalk, OH 44857
Phone (419) 668-1341
3703 Columbus Ave
Sandusky, OH 44870
Phone (419) 625-8085
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN.CNP.021800 | OH | Yes |
Addresses
Primary practice location
3202 Lawrence Ave
Huron, OH 44839-2143
Mailing address
3202 Lawrence Ave
Huron, OH 44839-2143
Phone (419) 370-8260
Other providers in Huron, OH
- Jamie M Brod
- Lucinda Shoaff Bunsey
- Margaret Carter
- Cassandra Lynn Case
- James Lee Champion
- City of Huron
- Clarity Counseling & Wellness, LLC
- Jacquelyn Clark
- Cleveland Clinic
- N. Gavin Connors
All providers in Huron, OH · Family Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.