Provider Demographics
NPI:1558818575
Name:PISTONE, JENNIFER-LEE (CNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER-LEE
Middle Name:
Last Name:PISTONE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:JENNIFER-LEE
Other - Middle Name:
Other - Last Name:HALAMEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:141 WAITE FARMS LN
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-1369
Mailing Address - Country:US
Mailing Address - Phone:216-538-0392
Mailing Address - Fax:
Practice Address - Street 1:7007 POWERS BLVD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5437
Practice Address - Country:US
Practice Address - Phone:440-743-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.019815363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily