Individual
JENNIFFER LEE PRICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3512 STELLHORN RD, FORT WAYNE, IN 46815-4631
(260) 483-9081
(260) 483-9196
Mailing address
3512 STELLHORN RD, FORT WAYNE, IN 46815-4631
(260) 483-9081
(260) 483-9196
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
025845
OH
363LG0600X
Gerontology Nurse Practitioner
4053258
KY
363LG0600X
Gerontology Nurse Practitioner
Primary
71008392A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025845
OHIO STATE LICENSE
OH
01
—
4053258
KENTUCKY STATE LICENSE
KY
01
—
71008392A
INDIANA STATE LICENSE
IN
Enumeration date
10/17/2018
Last updated
05/15/2026
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