Individual
JACQUELYN RENEE SHOWALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
354 W MAIN RD, CONNEAUT, OH 44030-2043
(440) 599-2262
Mailing address
354 W MAIN RD, CONNEAUT, OH 44030-2043
(440) 599-2262
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
CNP.0031978
OH
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.0031978
OH
Other
Enumeration date
01/19/2023
Last updated
02/24/2023
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