Provider Demographics
NPI:1063840213
Name:FROST, JENNIFER ANNE (CNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANNE
Last Name:FROST
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7225 OLD OAK BLVD
Mailing Address - Street 2:SUITE A210
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3339
Mailing Address - Country:US
Mailing Address - Phone:440-816-2761
Mailing Address - Fax:440-816-8065
Practice Address - Street 1:7225 OLD OAK BLVD
Practice Address - Street 2:SUITE A210
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3339
Practice Address - Country:US
Practice Address - Phone:440-816-2761
Practice Address - Fax:440-816-8065
Is Sole Proprietor?:No
Enumeration Date:2013-10-25
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.14883-NP363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology