Provider Demographics
NPI:1598414146
Name:BAHNSEN-WRIGHT, JENA SUE
Entity Type:Individual
Prefix:
First Name:JENA
Middle Name:SUE
Last Name:BAHNSEN-WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:OH
Mailing Address - Zip Code:43449-1113
Mailing Address - Country:US
Mailing Address - Phone:419-707-2586
Mailing Address - Fax:
Practice Address - Street 1:215 S ELM ST
Practice Address - Street 2:
Practice Address - City:WOODVILLE
Practice Address - State:OH
Practice Address - Zip Code:43469-1319
Practice Address - Country:US
Practice Address - Phone:419-707-2586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker