Healthcare Provider Details

I. General information

NPI: 1639714884
Provider Name (Legal Business Name): JENNA M TRIMMER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2019
Last Update Date: 11/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

882 S HAMILTON RD
COLUMBUS OH
43213-3003
US

IV. Provider business mailing address

882 S HAMILTON RD
COLUMBUS OH
43213-3003
US

V. Phone/Fax

Practice location:
  • Phone: 614-235-5555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.024645
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: