Healthcare Provider Details

I. General information

NPI: 1073952446
Provider Name (Legal Business Name): JENNIFER LYNN BROCKMEYER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER LYNN ALLEN NP-C

II. Dates (important events)

Enumeration Date: 06/19/2013
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6700 UNIVERSITY BLVD
DUBLIN OH
43016-3508
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-685-4614
  • Fax: 614-685-5025
Mailing address:
  • Phone: 614-685-4614
  • Fax: 614-685-5025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.15761
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.15761
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: