Provider Demographics
NPI:1447616842
Name:DIMEFF, JENNIFER (BSN, RN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:DIMEFF
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2660 DAYTON XENIA RD
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45434-6416
Mailing Address - Country:US
Mailing Address - Phone:937-458-2344
Mailing Address - Fax:937-458-2396
Practice Address - Street 1:2660 DAYTON XENIA RD
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45434-6416
Practice Address - Country:US
Practice Address - Phone:937-458-2344
Practice Address - Fax:937-458-2396
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-14
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH338258390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program