Provider Demographics
NPI:1710517586
Name:JESSEN, TOBI (RN)
Entity Type:Individual
Prefix:
First Name:TOBI
Middle Name:
Last Name:JESSEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6155 MAPLE GRV
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:OH
Mailing Address - Zip Code:45152-8455
Mailing Address - Country:US
Mailing Address - Phone:513-316-9432
Mailing Address - Fax:
Practice Address - Street 1:6155 MAPLE GRV
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:OH
Practice Address - Zip Code:45152-8455
Practice Address - Country:US
Practice Address - Phone:513-316-9432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-21
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.440446163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse