Provider Demographics
NPI:1952784050
Name:MAGNER, JILLIAN (RN, FNP)
Entity type:Individual
Prefix:MRS
First Name:JILLIAN
Middle Name:
Last Name:MAGNER
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:MS
Other - First Name:JILLIAN
Other - Middle Name:
Other - Last Name:GEHLFUSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, FNP
Mailing Address - Street 1:3101 BURNET AVE
Mailing Address - Street 2:CINCINNATI HEALTH DEPARTMENT
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229
Mailing Address - Country:US
Mailing Address - Phone:513-357-7289
Mailing Address - Fax:
Practice Address - Street 1:3101 BURNET AVE
Practice Address - Street 2:CINCINNATI HEALTH DEPARTMENT
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229
Practice Address - Country:US
Practice Address - Phone:513-357-7289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.386859390200000X
OHF05170162363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program