Individual
JESSICA LYNN ULLERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
3535 PENTAGON BLVD STE 220, BEAVERCREEK, OH 45431-1705
(937) 429-7350
(937) 431-2623
Mailing address
3535 PENTAGON BLVD STE 220, BEAVERCREEK, OH 45431-1705
(937) 429-7350
(937) 431-2623
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
APRN.CNP.024578
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0353060
—
OH
Enumeration date
06/10/2019
Last updated
11/17/2020
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