Healthcare Provider Details

I. General information

NPI: 1083209191
Provider Name (Legal Business Name): JENNIFER PATRICIA STEFANICH APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2021
Last Update Date: 05/04/2021
Certification Date: 05/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PERKINS SQ
AKRON OH
44308-1062
US

IV. Provider business mailing address

1 PERKINS SQ
AKRON OH
44308-1062
US

V. Phone/Fax

Practice location:
  • Phone: 330-543-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberAPRN.CNP.0027073
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: