Provider Demographics
NPI:1366914764
Name:STEGMILLER, JENNIFER ANN (NP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:STEGMILLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1466 NORTHWEST BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-3063
Mailing Address - Country:US
Mailing Address - Phone:614-598-9960
Mailing Address - Fax:
Practice Address - Street 1:1466 NORTHWEST BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-3063
Practice Address - Country:US
Practice Address - Phone:614-598-9960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5012150363LF0000X
OHAPRN.CNP.023778363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health