Provider Demographics
NPI:1790924355
Name:NEIL, JENNIFER S (CNP)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:S
Last Name:NEIL
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 1:1200 MELROSE DR
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-2828
Mailing Address - Country:US
Mailing Address - Phone:440-668-5625
Mailing Address - Fax:216-778-2448
Practice Address - Street 1:1200 MELROSE DR
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-2828
Practice Address - Country:US
Practice Address - Phone:440-668-5625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-05
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-03268363LA2200X
OHAPRN.CNP.03268363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health