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General NPI Number Information
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NPI Number | 1477058345
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Entity Type | Individual
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Provider Name | BRETT RANZ JENNINGS
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Gender | Male
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Dates
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Enumeration Date | 03/24/2018
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Last Update Date | 11/03/2022
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Provider Practice Location Address
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Address Line | 667 EASTLAND AVE SE
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City | WARREN
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State | OH
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Zip | 44484-4503
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Country | US
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Telephone | 240-686-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 380 WINDJAMMER DR
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City | COLUMBIANA
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State | OH
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Zip | 44408-9668
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 01088910A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 35.141730
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License Number State | OH
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