Provider Demographics
NPI:1578817193
Name:MESSENGER, JENNIFER A (CNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:MESSENGER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1945 LINCOLN WAY E
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-6965
Mailing Address - Country:US
Mailing Address - Phone:330-644-2747
Mailing Address - Fax:
Practice Address - Street 1:5147 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44319-3911
Practice Address - Country:US
Practice Address - Phone:330-644-2747
Practice Address - Fax:330-644-9815
Is Sole Proprietor?:No
Enumeration Date:2012-11-05
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA-13899 NP363LF0000X
OHAPRN.CNP.13899363LP0200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics