Provider Demographics
NPI:1255567533
Name:ELWELL-COSSIN, JEANETTE LEIGH (RN)
Entity type:Individual
Prefix:MS
First Name:JEANETTE
Middle Name:LEIGH
Last Name:ELWELL-COSSIN
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 1:2435 CLOVER BLOSSOM CT
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-9703
Mailing Address - Country:US
Mailing Address - Phone:614-875-2636
Mailing Address - Fax:614-875-2636
Practice Address - Street 1:2435 CLOVER BLOSSOM CT
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-9703
Practice Address - Country:US
Practice Address - Phone:614-875-2636
Practice Address - Fax:614-875-2636
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH291531163W00000X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health