Healthcare Provider Details

I. General information

NPI: 1538873005
Provider Name (Legal Business Name): JENNIFER LYNN DROUT FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER LYNN DROUT

II. Dates (important events)

Enumeration Date: 01/10/2023
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVE, ML 2008
CINCINNATI OH
45229-3039
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-7966
  • Fax: 513-636-7967
Mailing address:
  • Phone: 513-636-7966
  • Fax: 513-636-7967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number11226218-3102
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.427733
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11226218-4405
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11226218-8900
License Number StateUT
# 5
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number11226218-4405
License Number StateUT
# 6
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0032418
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: