Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | APRN.CNP.06428 | OH |
NPI | 1003892308 |
---|---|
Provider Name | Jennifer Ann Dehlman |
First Address | Cuyahoga Falls, OH 44223-1404 |
Second Address | Cuyahoga Falls, OH 44223-1404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2005 |
Last Update Date | 21/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2915920 | (05) | OH |