Individual
JASON STEVEN PENG
Active
Individual
JASON STEVEN PENG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.315551
OH
363L00000X
Nurse Practitioner
3012588
KY
363L00000X
Nurse Practitioner
433293
NY
363L00000X
Nurse Practitioner
COA.13491-NP
OH
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN.CNP.13491
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0071432
—
OH
05
—
7100301250
—
KY
Enumeration date
06/12/2012
Last updated
07/10/2025
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