Provider Demographics
NPI:1710291604
Name:DUNCAN, JENNIFER LORRAINE (CNP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LORRAINE
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-9031
Mailing Address - Country:US
Mailing Address - Phone:740-779-4222
Mailing Address - Fax:740-779-4257
Practice Address - Street 1:1000 VETERANS DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:OH
Practice Address - Zip Code:45640-9586
Practice Address - Country:US
Practice Address - Phone:740-395-8090
Practice Address - Fax:740-395-8197
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-03
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH11624-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3088966Medicaid