Healthcare Provider Details

I. General information

NPI: 1649026279
Provider Name (Legal Business Name): JENNIFER LYNN HOHMAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2024
Last Update Date: 04/25/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 CARRICK DR STE 170
MEDINA OH
44256-5392
US

IV. Provider business mailing address

4001 CARRICK DR STE 170
MEDINA OH
44256-5392
US

V. Phone/Fax

Practice location:
  • Phone: 330-721-8594
  • Fax:
Mailing address:
  • Phone: 330-721-8594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0036064
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: