Provider Demographics
NPI:1295179216
Name:TRENTHAM, JENNIFER LYNN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYNN
Last Name:TRENTHAM
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4378 EASTWOOD DR
Mailing Address - Street 2:APT 1115
Mailing Address - City:BATAVIA
Mailing Address - State:OH
Mailing Address - Zip Code:45103-2447
Mailing Address - Country:US
Mailing Address - Phone:513-765-9226
Mailing Address - Fax:
Practice Address - Street 1:4378 EASTWOOD DR
Practice Address - Street 2:APT 1115
Practice Address - City:BATAVIA
Practice Address - State:OH
Practice Address - Zip Code:45103-2447
Practice Address - Country:US
Practice Address - Phone:513-765-9226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-21
Last Update Date:2013-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH152613164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse