Healthcare Provider Details

I. General information

NPI: 1457295677
Provider Name (Legal Business Name): JENNIFER LYNN BALLINGER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 CHERRY ST
BLANCHESTER OH
45107-7907
US

IV. Provider business mailing address

8618 S STATE ROUTE 123
BLANCHESTER OH
45107-8465
US

V. Phone/Fax

Practice location:
  • Phone: 937-783-2461
  • Fax:
Mailing address:
  • Phone: 937-783-2461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN.385587
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: