Provider Demographics
NPI:1326537556
Name:KAUFMAN, JESSICA L (CNP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:KAUFMAN
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 1:2745 FORT AMANDA RD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-4805
Mailing Address - Country:US
Mailing Address - Phone:419-996-5700
Mailing Address - Fax:
Practice Address - Street 1:2745 FORT AMANDA RD
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805
Practice Address - Country:US
Practice Address - Phone:419-996-5700
Practice Address - Fax:419-996-5639
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.301662163W00000X
OHAPRN.CNP.022810363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse