Provider Demographics
NPI:1619380938
Name:BIDDLE, JENNIFER L (FNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:BIDDLE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1328 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-8458
Mailing Address - Country:US
Mailing Address - Phone:614-594-3097
Mailing Address - Fax:614-368-1178
Practice Address - Street 1:1328 FAIRWAY DR
Practice Address - Street 2:SUITE 321
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-8458
Practice Address - Country:US
Practice Address - Phone:614-595-1055
Practice Address - Fax:614-923-7813
Is Sole Proprietor?:No
Enumeration Date:2014-06-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.15913-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0104230Medicaid
OH0104230Medicaid