Provider Demographics
NPI:1598223414
Name:GERWIN, JEANNI A (FNP-CNP)
Entity Type:Individual
Prefix:MS
First Name:JEANNI
Middle Name:A
Last Name:GERWIN
Suffix:
Gender:F
Credentials:FNP-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 ELLEN KAY DR STE A
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-6358
Mailing Address - Country:US
Mailing Address - Phone:740-396-9967
Mailing Address - Fax:
Practice Address - Street 1:1125 ELLEN KAY DR STE A
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-6358
Practice Address - Country:US
Practice Address - Phone:740-396-9967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-10
Last Update Date:2020-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.023998363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily