Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | COA.14883-NP | OH |
N | 363LG0600X | Nurse Practitioner - Gerontology | COA.14883-NP | OH |
NPI | 1063840213 |
---|---|
Provider Name | Jennifer Anne Frost |
First Address | Middleburg Heights, OH 44130-3339 |
Second Address | Middleburg Heights, OH 44130-3339 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2013 |
Last Update Date | 05/04/2021 |