Individual
JENNY KAY MORTENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25147 TARA LYNN DR, NORTH OLMSTED, OH 44070-1292
(440) 364-2975
Mailing address
5269 DEVON DR, NORTH OLMSTED, OH 44070-3038
(440) 281-1485
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
SW801321
OH
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
03/09/2023
Last updated
03/09/2023
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