Provider Demographics
NPI:1366937781
Name:TESTRUTH, JENNIFER R (RN, BSN)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:R
Last Name:TESTRUTH
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:R
Other - Last Name:TESTRUTH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SKUFCA
Mailing Address - Street 1:2755 HILLSIDE RD
Mailing Address - Street 2:
Mailing Address - City:SEVEN HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44131-4510
Mailing Address - Country:US
Mailing Address - Phone:216-450-4427
Mailing Address - Fax:
Practice Address - Street 1:2755 HILLSIDE RD
Practice Address - Street 2:
Practice Address - City:SEVEN HILLS
Practice Address - State:OH
Practice Address - Zip Code:44131-4510
Practice Address - Country:US
Practice Address - Phone:216-450-4427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-27
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN344220163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse