Healthcare Provider Details

I. General information

NPI: 1366488397
Provider Name (Legal Business Name): JENNIFER ROWE-KELLER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 05/16/2022
Certification Date: 05/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 PLEASANTVILLE RD STE 101
LANCASTER OH
43130-3325
US

IV. Provider business mailing address

618 PLEASANTVILLE RD STE 101
LANCASTER OH
43130-3325
US

V. Phone/Fax

Practice location:
  • Phone: 740-475-0501
  • Fax: 740-653-7512
Mailing address:
  • Phone: 740-475-0501
  • Fax: 740-653-7512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberNP-05292
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: