Provider Demographics
NPI:1083052260
Name:ATHERTON, JENNIFER K (MA)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:K
Last Name:ATHERTON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:982 GRAFTON RD
Mailing Address - Street 2:APT. 1
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-4747
Mailing Address - Country:US
Mailing Address - Phone:740-366-4286
Mailing Address - Fax:
Practice Address - Street 1:982 GRAFTON RD
Practice Address - Street 2:APT. 1
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-4747
Practice Address - Country:US
Practice Address - Phone:740-366-4286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider