Provider Demographics
NPI:1538520051
Name:CINELLI, JENNIFER BLAISE (NP)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:BLAISE
Last Name:CINELLI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 GEORGETOWN CT
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-6007
Mailing Address - Country:US
Mailing Address - Phone:917-892-7218
Mailing Address - Fax:
Practice Address - Street 1:26110 EMERY RD STE 300
Practice Address - Street 2:
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44128-5788
Practice Address - Country:US
Practice Address - Phone:440-368-6868
Practice Address - Fax:440-368-6866
Is Sole Proprietor?:No
Enumeration Date:2016-03-10
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF340479-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily