Active NPI
Jenna Michniewicz
- Pharmacist
- Rossford, OH
National Provider Identifier
1376147629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302412941
- Practice address
- 9666 Olde US 20
Rossford, OH 43460-1710 - Phone
- (419) 872-9126
- NPI assigned
- Nov 27, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302412941 | MI | Primary |
Addresses
Primary practice location
9666 Olde US 20
Rossford, OH 43460-1710
Mailing address
7011 Quail Lakes Dr
Holland, OH 43528-9390
Phone (734) 751-9387
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302412941 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606435200000",
"number": "1376147629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7011 QUAIL LAKES DR",
"city": "HOLLAND",
"state": "OH",
"postal_code": "435289390",
"telephone_number": "734-751-9387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9666 OLDE US 20",
"city": "ROSSFORD",
"state": "OH",
"postal_code": "434601710",
"telephone_number": "419-872-9126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHNIEWICZ",
"first_name": "JENNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-27",
"last_updated": "2020-11-27",
"certification_date": "2020-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302412941",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rossford, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.