Healthcare Provider Details
I. General information
NPI: 1477957058
Provider Name (Legal Business Name): JANNIFER LYNNE SMEARSOLL APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/10/2014
Last Update Date: 07/25/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
371 LAFAYETTE ST
LONDON OH
43140-9326
US
IV. Provider business mailing address
700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US
V. Phone/Fax
- Phone: 740-845-6735
- Fax: 740-845-6736
- Phone: 740-845-6735
- Fax: 740-845-6736
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | COA 15955-NP |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LX0106X |
| Taxonomy | Occupational Health Nurse Practitioner |
| License Number | COA 15955-NP |
| License Number State | OH |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | APRN.CNP.15955 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: