Provider Demographics
NPI:1073015723
Name:NJIHIA, JENNIFER W (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:W
Last Name:NJIHIA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55714 BLACK PHEASANT DR
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:IN
Mailing Address - Zip Code:46561-8515
Mailing Address - Country:US
Mailing Address - Phone:574-707-2571
Mailing Address - Fax:
Practice Address - Street 1:55714 BLACK PHEASANT DR
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:IN
Practice Address - Zip Code:46561-8515
Practice Address - Country:US
Practice Address - Phone:574-707-2571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-08
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28190813A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN28190813AOtherREGISTERED NURSE