Provider Demographics
NPI:1346226727
Name:WRENN, JENNIFER ANN (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:WRENN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 COOPER RD
Mailing Address - Street 2:SUITE 420
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-8780
Mailing Address - Country:US
Mailing Address - Phone:615-839-5555
Mailing Address - Fax:614-839-5700
Practice Address - Street 1:495 COOPER RD
Practice Address - Street 2:SUITE 420
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8780
Practice Address - Country:US
Practice Address - Phone:614-839-5555
Practice Address - Fax:614-839-5100
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200400783207V00000X
OH3591083207VX0000X
GA068963207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2814217Medicaid
OHWR4229411Medicare PIN
NCI14154Medicare UPIN