Provider Demographics
NPI:1902109135
Name:CENNA, JENNIFER LYNNE (MSN RN CNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNNE
Last Name:CENNA
Suffix:
Gender:F
Credentials:MSN RN CNP
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Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:THIRD FLOOR BILLING SERVICES
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:440-256-8100
Mailing Address - Fax:440-256-8104
Practice Address - Street 1:9685 CHILLICOTHE RD
Practice Address - Street 2:
Practice Address - City:KIRTLAND
Practice Address - State:OH
Practice Address - Zip Code:44094-8503
Practice Address - Country:US
Practice Address - Phone:440-256-8100
Practice Address - Fax:440-256-8104
Is Sole Proprietor?:No
Enumeration Date:2010-12-09
Last Update Date:2013-04-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH167299163WM0705X
OHCOA. 12954-NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0069265Medicaid