Provider Demographics
NPI:1669871943
Name:PARKHURST, JENNIFER KAY (CNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KAY
Last Name:PARKHURST
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 1:309 SOUTH MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:LINDSEY
Mailing Address - State:OH
Mailing Address - Zip Code:43442
Mailing Address - Country:US
Mailing Address - Phone:419-665-4007
Mailing Address - Fax:
Practice Address - Street 1:2751 BAY PARK DR
Practice Address - Street 2:SUITE 303
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-4921
Practice Address - Country:US
Practice Address - Phone:419-690-7686
Practice Address - Fax:419-693-2931
Is Sole Proprietor?:No
Enumeration Date:2014-08-22
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.16172-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily