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Individual

MRS. KATHY M JETT

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
300 MEDICAL PARK DR, SUITE 205, DOVER, OH 44622-2073
(330) 364-4600
(330) 364-3338
Mailing address
300 MEDICAL PARK DR, SUITE 205, DOVER, OH 44622-2073
(330) 364-4600
(330) 364-3338

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
04286
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2358470
OH
Enumeration date
06/14/2006
Last updated
07/08/2007
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