Provider Demographics
NPI:1376545525
Name:DUNNIGAN-FENTON, JENNIFER ANN (FNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:DUNNIGAN-FENTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9400 READING RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:OH
Mailing Address - Zip Code:45215-3401
Mailing Address - Country:US
Mailing Address - Phone:513-563-6934
Mailing Address - Fax:513-769-2622
Practice Address - Street 1:9400 READING RD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:OH
Practice Address - Zip Code:45215-3401
Practice Address - Country:US
Practice Address - Phone:513-563-6934
Practice Address - Fax:513-769-2622
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN254351363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2217676Medicaid
OHFENP04021Medicare UPIN