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NPI Code Detail

MEDICARE: JENNIFER WIDENER

MEDICARE:   JENNIFER  WIDENER
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1174455661
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER WIDENER
Provider Business Mailing Address
First Line : 2347 VINE ST
Second Line :
City : CINCINNATI
State : OH
Zip : 45219-1745
Country : US
Telephone Number : 513-621-1117
Fax Number :
Provider Business Practice Location Address
First Line : 2347 VINE ST
Second Line :
City : CINCINNATI
State : OH
Zip : 45219-1745
Country : US
Telephone Number : 513-621-1117
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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Directions to “ JENNIFER WIDENER ” Practice Location

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