Healthcare Provider Details

I. General information

NPI: 1467241638
Provider Name (Legal Business Name): JESSICA ENSMINGER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7525 WARREN SHARON RD
BROOKFIELD OH
44403-9796
US

IV. Provider business mailing address

7525 WARREN SHARON RD
BROOKFIELD OH
44403-9796
US

V. Phone/Fax

Practice location:
  • Phone: 330-369-9503
  • Fax:
Mailing address:
  • Phone: 330-369-9503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.118908
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: