Provider Demographics
NPI:1598916108
Name:HANSHAW, JENNIFER LYNN (LPN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:HANSHAW
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 WILLIS DR LOT 128
Mailing Address - Street 2:
Mailing Address - City:SOUTH ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-7419
Mailing Address - Country:US
Mailing Address - Phone:740-452-2329
Mailing Address - Fax:
Practice Address - Street 1:80 N PEMBROKE AVE
Practice Address - Street 2:
Practice Address - City:SOUTH ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-6261
Practice Address - Country:US
Practice Address - Phone:740-624-5874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 123486164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse