Healthcare Provider Details

I. General information

NPI: 1558922286
Provider Name (Legal Business Name): JENNIFER SUE ARHIN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2019
Last Update Date: 06/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

807 E WASHINGTON ST., STE 220
MEDINA OH
44256
US

IV. Provider business mailing address

6609 AMSTERDAM DR
LIBERTY TOWNSHIP OH
45044-9746
US

V. Phone/Fax

Practice location:
  • Phone: 330-536-3746
  • Fax:
Mailing address:
  • Phone: 513-594-1561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number024847
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: