Healthcare Provider Details

I. General information

NPI: 1467508895
Provider Name (Legal Business Name): DEBRA ANN LAJEUNESSE RN,CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 S CLEVELAND AVE
WESTERVILLE OH
43081-8971
US

IV. Provider business mailing address

5844 NICHOLS LN
JOHNSTOWN OH
43031-9578
US

V. Phone/Fax

Practice location:
  • Phone: 614-898-4360
  • Fax:
Mailing address:
  • Phone: 740-967-4919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberNP-5387
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: