Individual
JENNIFER PRENDERGAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
719 OHIO PIKE, CINCINNATI, OH 45245-2131
(513) 853-9700
(513) 852-8966
Mailing address
505 CORPORATE CENTER DR UNIT A, VANDALIA, OH 45377-1168
(937) 898-2098
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN.CNP.0027542
OH
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.0027542
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0383163
—
OH
Enumeration date
09/17/2020
Last updated
02/07/2022
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