Healthcare Provider Details

I. General information

NPI: 1346226727
Provider Name (Legal Business Name): JENNIFER ANN WRENN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 11/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 COOPER RD SUITE 420
WESTERVILLE OH
43081-8780
US

IV. Provider business mailing address

495 COOPER RD SUITE 420
WESTERVILLE OH
43081-8780
US

V. Phone/Fax

Practice location:
  • Phone: 614-839-5555
  • Fax: 614-839-5100
Mailing address:
  • Phone: 615-839-5555
  • Fax: 614-839-5700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number200400783
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number3591083
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number068963
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: