Broderick, Jennifer L

Broderick, Jennifer L is an individual health care provider with primary practice located at 79 W Main St , Lexington OH 44904-1113. She recently has only one registered license in Other Service Providers / Contractor, which is considered as her primary health care specialty. Broderick, Jennifer L can be contacted via phone (419) 884-1302.

Contact Information

Primary practice address
79 W Main St Lexington OH 44904-1113
Phone: (419) 884-1302
Fax: (419) 884-8398
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Contractor 171W00000X 2539088 Ohio

Profile Details

NPI number 1144258807
LBN Legal business name Broderick, Jennifer L
Credentials CAREGIVER
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2006
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144258807 NPPES
Ohio MEDICAID 2539088

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