Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | 35.120973 | OH |
N | 207X00000X | Orthopaedic Surgeon | 59514 | MA |
NPI | 1083768154 |
---|---|
Provider Name | L Candace Jennings |
First Address | Columbus, OH 43210-2205 |
Second Address | Dublin, OH 43017-1436 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 18/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PENDING | (05) | OH |