Healthcare Provider Details

I. General information

NPI: 1326537556
Provider Name (Legal Business Name): JESSICA L KAUFMAN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2018
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3224 JARVIS RD
LIMA OH
45807-2213
US

IV. Provider business mailing address

2745 FORT AMANDA RD
LIMA OH
45805-4805
US

V. Phone/Fax

Practice location:
  • Phone: 419-996-5757
  • Fax: 419-996-5913
Mailing address:
  • Phone: 419-996-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.301662
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.022810
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: