Healthcare Provider Details

I. General information

NPI: 1942735857
Provider Name (Legal Business Name): JENI APTHORPE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2017
Last Update Date: 12/04/2020
Certification Date: 12/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 E MARKET ST STE 30
WARREN OH
44484-2259
US

IV. Provider business mailing address

5000 E MARKET ST STE 30
WARREN OH
44484-2259
US

V. Phone/Fax

Practice location:
  • Phone: 330-856-9699
  • Fax: 330-856-9935
Mailing address:
  • Phone: 330-856-9699
  • Fax: 330-856-9935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.020501
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number391790
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: