Healthcare Provider Details

I. General information

NPI: 1306328398
Provider Name (Legal Business Name): JENI-LYN CALABRO ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENI-LYN DUKE RN

II. Dates (important events)

Enumeration Date: 09/05/2018
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 REGENT ST STE 200
COLUMBUS OH
43219-6229
US

IV. Provider business mailing address

2540 BASS WAY
HOLLYWOOD FL
33026-3681
US

V. Phone/Fax

Practice location:
  • Phone: 877-870-1775
  • Fax: 614-968-8840
Mailing address:
  • Phone: 754-234-1676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9199076
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: