Individual
JENA C PRUDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5494 BULLFINCH DR, WESTERVILLE, OH 43081-8606
(419) 217-4314
Mailing address
5494 BULLFINCH DR, WESTERVILLE, OH 43081-8606
(419) 217-4314
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2570141
—
OH
Enumeration date
09/25/2020
Last updated
09/25/2020
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