Individual
JENNIFER ANN MARTNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, NPC, MSN
Contact information
Practice address
17876 SAINT CLAIR AVE, CLEVELAND, OH 44110-2602
(216) 486-6512
Mailing address
17876 SAINT CLAIR AVE, CLEVELAND, OH 44110-2602
(216) 486-6512
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
COA14445, RN 296632
OH
363LG0600X
Gerontology Nurse Practitioner
COA14445, RN296632
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AG0313017
AANP
OH
01
—
COA14445
RN, COA, AANP
OH
01
—
RN296632
RN
OH
Enumeration date
05/06/2013
Last updated
06/17/2013
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