Provider Demographics
NPI:1477828374
Name:JENNINGS, JULIA NICOLE (LPN)
Entity Type:Individual
Prefix:MISS
First Name:JULIA
Middle Name:NICOLE
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3394 COMPTON DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-3323
Mailing Address - Country:US
Mailing Address - Phone:614-843-1538
Mailing Address - Fax:614-532-5501
Practice Address - Street 1:3394 COMPTON DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-3323
Practice Address - Country:US
Practice Address - Phone:614-843-1538
Practice Address - Fax:614-532-5501
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-12
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN133216 IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse