Provider Demographics
NPI:1598011587
Name:GUY, JENNY JAYOUNG (NP)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:JAYOUNG
Last Name:GUY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:460 W 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43210-1240
Mailing Address - Country:US
Mailing Address - Phone:614-293-0423
Mailing Address - Fax:614-365-4971
Practice Address - Street 1:460 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1240
Practice Address - Country:US
Practice Address - Phone:614-293-0423
Practice Address - Fax:614-365-4971
Is Sole Proprietor?:No
Enumeration Date:2012-07-27
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22129363L00000X
OH019956-CNP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner