Healthcare Provider Details

I. General information

NPI: 1912434069
Provider Name (Legal Business Name): JENA TERRAZZINO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2017
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6417 COLUMBUS PIKE
LEWIS CENTER OH
43035-9719
US

IV. Provider business mailing address

6417 COLUMBUS PIKE
LEWIS CENTER OH
43035-9719
US

V. Phone/Fax

Practice location:
  • Phone: 740-888-1290
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03334746
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: