Provider Demographics
NPI:1093232449
Name:MITCHELL DENNEY, JENNIFER SUSANNE (CNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SUSANNE
Last Name:MITCHELL DENNEY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3710 SNYDER DOMER RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45502-8964
Mailing Address - Country:US
Mailing Address - Phone:937-408-5381
Mailing Address - Fax:
Practice Address - Street 1:3455 MILL RUN DR STE 310
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-9082
Practice Address - Country:US
Practice Address - Phone:833-358-2665
Practice Address - Fax:855-362-0779
Is Sole Proprietor?:No
Enumeration Date:2017-08-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.326828163W00000X
OHAPRN.CNP.021075363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse