Provider Demographics
NPI:1821408493
Name:CAREY, JENNIFER M (LPN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:CAREY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:M
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:651 S LIMESTONE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45505-1965
Mailing Address - Country:US
Mailing Address - Phone:937-399-9500
Mailing Address - Fax:937-342-4242
Practice Address - Street 1:651 S LIMESTONE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45505-1965
Practice Address - Country:US
Practice Address - Phone:937-324-1111
Practice Address - Fax:937-525-4542
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.153271-M-IV164W00000X
OHLPN.153271.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse