Basic Information
Provider Information
NPI: 1801844923
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DENNY
FirstName: JEAN
MiddleName: M.
NamePrefix:  
NameSuffix:  
Credential: CNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2830 VICTORY PKWY
Address2: STE 310
City: CINCINNATI
State: OH
PostalCode: 452063700
CountryCode: US
TelephoneNumber: 5132453444
FaxNumber: 5132453449
Practice Location
Address1: 222 PIEDMONT AVE
Address2: STE 4000
City: CINCINNATI
State: OH
PostalCode: 452194231
CountryCode: US
TelephoneNumber: 5134758500
FaxNumber: 5134758510
Other Information
ProviderEnumerationDate: 05/04/2006
LastUpdateDate: 12/12/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200XRN-202171OHY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

ID Information
IDTypeStateIssuerDescription
249932705OH MEDICAID
7801384405KY MEDICAID
20038432005IN MEDICAID


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