Jacquelyn Wrenn, APRN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.0028181 Issued in OH

Practice address

89 Sylvania Dr
Dayton, OH 45440-3281

Phone

(937) 320-2020

Fax

(513) 984-4240

NPI assigned

Feb 26, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jacquelyn Davanzo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacquelyn.wrenn.p1@direct.cei.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cei Physicians PSC LLC

  • Ophthalmology Physician
  • Cincinnati, OH
  • NPI 1942296298
  NPD
• Cei Physicians PSC, LLC

  • Ambulatory Surgical Clinic/Center
  • Richmond Heights, OH
  • NPI 1891406328
  NPD

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

{
    "created_epoch": "1614297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1457945776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE # I32",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-402-1327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 SYLVANIA DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454403281",
            "telephone_number": "937-320-2020",
            "fax_number": "513-984-4240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9500 Euclid Ave # I32",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441950001",
            "country_code": "US",
            "telephone_number": "216-402-1327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WRENN",
        "first_name": "JACQUELYN",
        "name_prefix": "Ms.",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-26",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "APRN.CNP.0028181",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0028181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELYN",
            "last_name": "DAVANZO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shanell Lashay Worthy
• Andrew J Wourms, CRNA
• Diana Brown Wourms, P.T.
• WP Healthcare LLC
• Joseph K Wray, M.D.
• Wright Health Inc
• Wright State Physicians
• Wright State Physicians
• Wright State Physicians Inc
• Wright State Physicians Inc

• Family Nurse Practitioner in Dayton, OH
• Providers in Dayton, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.