Gonzalez, Jennifer W

Gonzalez, Jennifer W is an individual health care provider with primary practice located at 725 University Blvd , Beavercreek OH 45324-2640. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Gonzalez, Jennifer W can be contacted via phone (937) 245-7200.

Contact Information

Primary practice address
725 University Blvd Beavercreek OH 45324-2640
Phone: (937) 245-7200
Fax: (937) 245-7999
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9112057 Florida
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 50.007105RX Ohio

Profile Details

NPI number 1154519239
LBN Legal business name Gonzalez, Jennifer W
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 14th, 2007
Last updated Sep 21st, 2022 - about 3 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 1154519239 NPPES
Florida MEDICAID 104159800
Florida MEDICAID 0462499
Florida Other 0EJPX

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