Healthcare Provider Details

I. General information

NPI: 1942965256
Provider Name (Legal Business Name): JESSICA LYNN TOTIN NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2021
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 MCKAY CT STE 100
BOARDMAN OH
44512-5786
US

IV. Provider business mailing address

835 MCKAY CT STE 100
BOARDMAN OH
44512-5786
US

V. Phone/Fax

Practice location:
  • Phone: 330-729-8970
  • Fax:
Mailing address:
  • Phone: 330-729-8970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP024467
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0030182
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: