Provider Demographics
NPI:1588086250
Name:AUSIELLO, JENIFER (DNP, APRN)
Entity type:Individual
Prefix:
First Name:JENIFER
Middle Name:
Last Name:AUSIELLO
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32390 DILLARD RD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-9544
Mailing Address - Country:US
Mailing Address - Phone:702-838-0054
Mailing Address - Fax:702-998-2594
Practice Address - Street 1:400 INTERNATIONAL WAY STE 200
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-7004
Practice Address - Country:US
Practice Address - Phone:541-844-0151
Practice Address - Fax:702-998-2594
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-14
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN001662363L00000X, 363LA2200X, 363LG0600X, 363LP2300X
OR202109870NP-PP363LP2300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care