MEDICARE: JENIFER LYNN SAPP RN, BSN

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.446309	OH

General Provider Information

NPI Number	:	1477228492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENIFER LYNN SAPP RN, BSN

Provider Business Mailing Address
First Line	:	1283 MANNER DR
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44905-1637
Country	:	US
Telephone Number	:	419-571-7712
Fax Number	:

Provider Business Practice Location Address
First Line	:	1283 MANNER DR
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44905-1637
Country	:	US
Telephone Number	:	419-571-7712
Fax Number	:

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

Provider Enumeration Date	:	08/11/2021
Last Update Date	:	09/15/2025

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