Provider Demographics
NPI:1306375035
Name:JENNINGS, AMANDA (FNP-C)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 PIEDMONT AVE STE 2200
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-4238
Mailing Address - Country:US
Mailing Address - Phone:513-875-8690
Mailing Address - Fax:
Practice Address - Street 1:222 PIEDMONT AVE STE 2200
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-4238
Practice Address - Country:US
Practice Address - Phone:513-875-8690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-06
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1734108207Q00000X, 207X00000X
OHAPRNCNP021269363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery