Sundstrom, Jennifer

Sundstrom, Jennifer is an sole proprietor health care provider with primary practice located at 3737 Southern Blvd Ste 2000 , Kettering OH 45429-1285. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Primary Care is her primary health care specialty. Sundstrom, Jennifer can be contacted via phone (937) 228-4126.

Contact Information

Primary practice address
3737 Southern Blvd Ste 2000 Kettering OH 45429-1285
Phone: (937) 228-4126
Fax: (937) 228-0247
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X RN.273729 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X RN.273729 Ohio

Profile Details

NPI number 1528420650
LBN Legal business name Sundstrom, Jennifer
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 28th, 2016
Last updated Mar 8th, 2021 - about 4 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 1528420650 NPPES
Ohio MEDICAID 0165479

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