Provider Demographics
NPI:1669050621
Name:STEWART, JENNIFER M (APRN-CNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:STEWART
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:M
Other - Last Name:OKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVE ML 5021
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-4225
Mailing Address - Fax:
Practice Address - Street 1:3333 BURNET AVE ML 1013
Practice Address - Street 2:MARK
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-4466
Practice Address - Fax:513-636-5846
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0030503363L00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program