MEDICARE: MS. LATONYA JENNINGS MSN, RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN.371607	OH

General Provider Information

NPI Number	:	1104005305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LATONYA JENNINGS MSN, RN

Provider Business Mailing Address
First Line	:	1712 STONYBROOK DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-3206
Country	:	US
Telephone Number	:	513-413-0706
Fax Number	:

Provider Business Practice Location Address
First Line	:	6240 HAMILTON AVE STE 1
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45224-2000
Country	:	US
Telephone Number	:	513-201-7972
Fax Number	:	283-333-1802

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2007
Last Update Date	:	04/28/2026

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