Provider Demographics
NPI:1104225093
Name:RUMMAN, JODI (CNP)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:RUMMAN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:JODI
Other - Middle Name:
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:2200 JEFFERSON AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-7102
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3841 NAVARRE AVE
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3435
Practice Address - Country:US
Practice Address - Phone:419-691-8132
Practice Address - Fax:419-691-2061
Is Sole Proprietor?:No
Enumeration Date:2014-08-18
Last Update Date:2024-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.16062363LG0600X
OHCOA16062NP364SA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH370191OtherMEDICARE
OH0112027Medicaid
OH0112027Medicaid
OH9389631Medicare PIN