Provider Demographics
NPI:1467145193
Name:VU, JENNIFER KIM (PA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KIM
Last Name:VU
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:349 ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:OAKWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45419-1724
Mailing Address - Country:US
Mailing Address - Phone:614-364-6319
Mailing Address - Fax:
Practice Address - Street 1:999 BRUBAKER DR STE 3
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-3667
Practice Address - Country:US
Practice Address - Phone:937-668-9850
Practice Address - Fax:937-668-8668
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2024-07-22
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant