Provider Demographics
NPI:1366095424
Name:WEHNER, JENNIFER ELIZABETH (APRNCNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ELIZABETH
Last Name:WEHNER
Suffix:
Gender:F
Credentials:APRNCNP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:ELIZABETH
Other - Last Name:PRUDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2001 E ROYALTON RD
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-2811
Mailing Address - Country:US
Mailing Address - Phone:440-717-5800
Mailing Address - Fax:440-717-6164
Practice Address - Street 1:2001 E ROYALTON RD
Practice Address - Street 2:
Practice Address - City:BROADVIEW HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44147-2811
Practice Address - Country:US
Practice Address - Phone:440-717-5800
Practice Address - Fax:440-717-6164
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.024735363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily