Healthcare Provider Details

I. General information

NPI: 1619333168
Provider Name (Legal Business Name): WHITNEY TERESA JABLONSKI CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: WHITNEY TERESA ONDRUS

II. Dates (important events)

Enumeration Date: 01/13/2016
Last Update Date: 11/03/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4118 STARR AVE
OREGON OH
43616-2444
US

IV. Provider business mailing address

4118 STARR AVE
OREGON OH
43616-2444
US

V. Phone/Fax

Practice location:
  • Phone: 419-349-0752
  • Fax:
Mailing address:
  • Phone: 419-349-0752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.370537-1
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704292462
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28213496A
License Number StateIN
# 4
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCOA.18600-NA
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: