Provider Demographics
NPI:1710198619
Name:SKEENS, JENNIFER AGNES (LPN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:AGNES
Last Name:SKEENS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 DEER PATH CT N
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062
Mailing Address - Country:US
Mailing Address - Phone:614-562-8945
Mailing Address - Fax:
Practice Address - Street 1:114 DEER PATH CT N
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062
Practice Address - Country:US
Practice Address - Phone:614-562-8945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 117070164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse