Provider Demographics
NPI:1861036089
Name:JENNINGS, RACHAEL LYNN (CNP)
Entity Type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:LYNN
Last Name:JENNINGS
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 1:414 OAKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:OAKWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45409-2217
Mailing Address - Country:US
Mailing Address - Phone:937-422-0225
Mailing Address - Fax:
Practice Address - Street 1:414 OAKWOOD AVE
Practice Address - Street 2:
Practice Address - City:OAKWOOD
Practice Address - State:OH
Practice Address - Zip Code:45409-2217
Practice Address - Country:US
Practice Address - Phone:937-560-2011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-30
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.025591363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily