Midtlien, Jennifer Lynn

Midtlien, Jennifer Lynn is an individual health care provider with primary practice located at 5300 Far Hills Ave , Dayton OH 45429-2381. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Midtlien, Jennifer Lynn can be contacted via phone (937) 433-7536.

Contact Information

Primary practice address
5300 Far Hills Ave Dayton OH 45429-2381
Phone: (937) 433-7536
Fax: (937) 433-9612
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X RN260615 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 364SA2200X 11935-NP Ohio

Profile Details

NPI number 1639489545
LBN Legal business name Midtlien, Jennifer Lynn
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2010
Last updated Aug 3rd, 2016 - about 8 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 1639489545 NPPES
Ohio Other 9328817 AETNA
Ohio MEDICAID 0058747 AETNA
Ohio Other 421534506186 AETNA
Ohio Other 000000745200 AETNA
Ohio Other P01005063 AETNA

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