Healthcare Provider Details

I. General information

NPI: 1417847237
Provider Name (Legal Business Name): JENNIFER KOHLS MSN, CNP, AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2025
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 S GRANT AVE
COLUMBUS OH
43215-4701
US

IV. Provider business mailing address

2467 ST RT 180
CHILLICOTHEE OH
45601
US

V. Phone/Fax

Practice location:
  • Phone: 502-387-1417
  • Fax:
Mailing address:
  • Phone: 502-387-1417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberAPRN.CNP.0042787
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number534127
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: