Provider Demographics
NPI:1598968596
Name:WEAN, JENNIFER KAY (PA-C)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:KAY
Last Name:WEAN
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:5400 FRANTZ RD
Mailing Address - Street 2:STE 250
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4144
Mailing Address - Country:US
Mailing Address - Phone:614-544-6155
Mailing Address - Fax:614-544-6370
Practice Address - Street 1:931 CHATHAM LN
Practice Address - Street 2:SUITE 200
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2417
Practice Address - Country:US
Practice Address - Phone:614-533-5500
Practice Address - Fax:614-533-5593
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2022-01-25
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Provider Licenses
StateLicense IDTaxonomies
OH50.002073363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHWEPA29191Medicare PIN