Healthcare Provider Details

I. General information

NPI: 1093306839
Provider Name (Legal Business Name): JENNIFER GELSKE CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2021
Last Update Date: 12/31/2024
Certification Date: 12/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41201 SCHADDEN RD
ELYRIA OH
44035-2249
US

IV. Provider business mailing address

37559 AMBER WAY
NORTH RIDGEVILLE OH
44039-4821
US

V. Phone/Fax

Practice location:
  • Phone: 440-324-0400
  • Fax: 440-324-0441
Mailing address:
  • Phone: 216-469-2134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0028341
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: