Provider Demographics
NPI:1487926283
Name:RESER, JONI LYNNE (APRN-CNP, ACNP-BC)
Entity type:Individual
Prefix:MS
First Name:JONI
Middle Name:LYNNE
Last Name:RESER
Suffix:
Gender:F
Credentials:APRN-CNP, ACNP-BC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3170 KETTERING BLVD BLDG B3
Mailing Address - Street 2:
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1924
Mailing Address - Country:US
Mailing Address - Phone:937-991-3188
Mailing Address - Fax:937-223-9811
Practice Address - Street 1:3130 N COUNTY ROAD 25A STE 212
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-1337
Practice Address - Country:US
Practice Address - Phone:937-335-0061
Practice Address - Fax:937-339-9336
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-08
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH21204111363LA2100X
OHAPRN.CNP.13242363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0065517Medicaid
OH0065517Medicaid