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General NPI Number Information
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NPI Number | 1538629282
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Entity Type | Individual
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Provider Name | MS. JENNIE TAN
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Gender | Female
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Dates
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Enumeration Date | 03/20/2019
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 7675 WELLNESS WAY
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City | WEST CHESTER
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State | OH
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Zip | 45069-2509
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Country | US
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Telephone | 513-475-8500
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Fax | 513-475-7440
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Provider Business Mailing Address
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Address Line | PO BOX 636256
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City | CINCINNATI
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State | OH
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Zip | 45263-6256
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Country | US
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Telephone | 513-585-6200
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Fax | 513-245-3672
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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 | 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 #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 34.018146
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License Number State | OH
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