Provider Demographics
NPI:1306557384
Name:STANKIEWICZ, JENNIFER LEANNE (BS, BA, MA/TL)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LEANNE
Last Name:STANKIEWICZ
Suffix:
Gender:F
Credentials:BS, BA, MA/TL
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:LEANNE
Other - Last Name:DUCKWORTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS, BA
Mailing Address - Street 1:7460 WOOSTER PIKE RD
Mailing Address - Street 2:
Mailing Address - City:SEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44273-9717
Mailing Address - Country:US
Mailing Address - Phone:440-668-8364
Mailing Address - Fax:
Practice Address - Street 1:7460 WOOSTER PIKE RD
Practice Address - Street 2:
Practice Address - City:SEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44273-9717
Practice Address - Country:US
Practice Address - Phone:440-668-8364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-09
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No374U00000XNursing Service Related ProvidersHome Health Aide