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General NPI Number Information
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NPI Number | 1497512545
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Entity Type | Individual
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Provider Name | DESIREE JUNGFLEISCH MSN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/05/2024
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Last Update Date | 03/05/2024
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Provider Practice Location Address
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Address Line | 142 W 5TH ST
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City | EAST LIVERPOOL
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State | OH
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Zip | 43920-2901
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Country | US
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Telephone | 330-385-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 417 PRIMROSE LN
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City | EAST LIVERPOOL
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State | OH
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Zip | 43920-9472
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Country | US
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Telephone | 330-831-7794
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.0035947
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License Number State | OH
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