Individual
MRS. JACQUELYN M DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1207 W STATE ST, SUITE N, ALLIANCE, OH 44601-4686
(330) 821-3244
(330) 868-5782
Mailing address
1207 W STATE ST, SUITE N, ALLIANCE, OH 44601-4686
(330) 821-3244
(330) 868-5782
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
COA.18811-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168552
—
OH
Enumeration date
02/26/2016
Last updated
03/30/2017
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