Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 4704223719 | MI |
N | 363LP0200X | Nurse Practitioner - Pediatrics | 4704223719 | MI |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | APRN.CNP.15702 | OH |
NPI | 1033273776 |
---|---|
Provider Name | Jennifer Marie Tassinari |
First Address | Cleveland, OH 44195-0001 |
Second Address | Cleveland, OH 44195-4259 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 11/11/2021 |