Individual
JENNIFER LYNNE DATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
3124 BEAN OLLER RD, DELAWARE, OH 43015-9220
(740) 369-6516
Mailing address
3124 BEAN OLLER RD, DELAWARE, OH 43015-9220
(740) 369-6516
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
10801-NP
OH
363LF0000X
Family Nurse Practitioner
10801-NP
OH
Other
Enumeration date
04/05/2006
Last updated
12/26/2011
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