Provider Demographics
NPI:1316692015
Name:OLSHAWSKY, JEN LISA
Entity type:Individual
Prefix:
First Name:JEN
Middle Name:LISA
Last Name:OLSHAWSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 271
Mailing Address - Street 2:
Mailing Address - City:NEFFS
Mailing Address - State:OH
Mailing Address - Zip Code:43940-0271
Mailing Address - Country:US
Mailing Address - Phone:740-340-7265
Mailing Address - Fax:
Practice Address - Street 1:65140 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:NEFFS
Practice Address - State:OH
Practice Address - Zip Code:43940-6705
Practice Address - Country:US
Practice Address - Phone:740-340-7265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant