Provider Demographics
NPI:1366488397
Name:ROWE-KELLER, JENNIFER (CNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:ROWE-KELLER
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 1:618 PLEASANTVILLE RD
Mailing Address - Street 2:STE 101
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-3325
Mailing Address - Country:US
Mailing Address - Phone:740-475-0501
Mailing Address - Fax:740-653-7512
Practice Address - Street 1:618 PLEASANTVILLE RD
Practice Address - Street 2:STE 101
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3325
Practice Address - Country:US
Practice Address - Phone:740-475-0501
Practice Address - Fax:740-653-7512
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-05292363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2396821Medicaid
OHRONP19101Medicare ID - Type Unspecified
OHP76662Medicare UPIN