Healthcare Provider Details

I. General information

NPI: 1700713872
Provider Name (Legal Business Name): JENNIFER MORIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3251 WESTERVILLE RD STE C
COLUMBUS OH
43224-3751
US

IV. Provider business mailing address

2100 STELLA CT
COLUMBUS OH
43215-1011
US

V. Phone/Fax

Practice location:
  • Phone: 614-252-8402
  • Fax:
Mailing address:
  • Phone: 614-252-8402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number2270-0725
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: