Provider Demographics
NPI:1952355950
Name:ATKINSON, JENNIFER ANN (ACNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:ANN
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:103 MCKNIGHT DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-4890
Mailing Address - Country:US
Mailing Address - Phone:513-217-6400
Mailing Address - Fax:513-217-6037
Practice Address - Street 1:103 MCKNIGHT DR
Practice Address - Street 2:SUITE A
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-4890
Practice Address - Country:US
Practice Address - Phone:513-217-6400
Practice Address - Fax:513-217-6037
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP05239363LA2100X
OHRN247919363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH328178OtherAMERIGROUP
OH208679830031OtherCARESOURCE
OH2332238Medicaid
OH000000524479OtherANTHEM
OHATNP23831Medicare PIN
OH208679830031OtherCARESOURCE
OH2332238Medicaid