Provider Demographics
NPI:1083624290
Name:TABIN, JENIFER F (CNM)
Entity Type:Individual
Prefix:
First Name:JENIFER
Middle Name:F
Last Name:TABIN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25350 ROCKSIDE RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44146-7110
Mailing Address - Country:US
Mailing Address - Phone:440-232-8381
Mailing Address - Fax:
Practice Address - Street 1:3311 BROADVIEW RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-3315
Practice Address - Country:US
Practice Address - Phone:216-661-1545
Practice Address - Fax:216-661-2238
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN241441163W00000X
OH02988NM176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH995259Medicaid
OHNM03831Medicare PIN