Provider Demographics
NPI:1396475711
Name:FOREN, JENNIFER
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:FOREN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 CORPORATE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-4442
Mailing Address - Country:US
Mailing Address - Phone:330-203-1614
Mailing Address - Fax:216-400-9196
Practice Address - Street 1:1320 CORPORATE DR STE 100
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-4442
Practice Address - Country:US
Practice Address - Phone:330-203-1614
Practice Address - Fax:216-400-9196
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-16
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0031511363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health