Basic Information
| Provider Information | |||||||||
| NPI: | 1023627841 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SWISHER | ||||||||
| FirstName: | JENNY | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 62 RENFREW DR | ||||||||
| Address2: | |||||||||
| City: | SHELBY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 448751822 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4199893180 | ||||||||
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| Practice Location | |||||||||
| Address1: | 375 N LEXINGTON SPRINGMILL RD | ||||||||
| Address2: | |||||||||
| City: | ONTARIO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 449063812 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4195280047 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2020 | ||||||||
| LastUpdateDate: | 07/28/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | APRN.CNP.0026996 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.