Provider Demographics
NPI:1083386502
Name:CIRINCIONE KERKHEIDE, JENIFER (PHARMD)
Entity type:Individual
Prefix:
First Name:JENIFER
Middle Name:
Last Name:CIRINCIONE KERKHEIDE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4969 LANDER RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:OH
Mailing Address - Zip Code:44022
Mailing Address - Country:US
Mailing Address - Phone:216-225-7664
Mailing Address - Fax:
Practice Address - Street 1:1825 SNOW RD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44134
Practice Address - Country:US
Practice Address - Phone:216-739-4120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-03
Last Update Date:2021-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03129302183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist