Provider Demographics
NPI:1588469324
Name:HALLOCK, JENNIFER BRIANA (MSN, WHNP-BC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:BRIANA
Last Name:HALLOCK
Suffix:
Gender:
Credentials:MSN, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3774 MUIRFIELD DR
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-8817
Mailing Address - Country:US
Mailing Address - Phone:330-322-3900
Mailing Address - Fax:
Practice Address - Street 1:3774 MUIRFIELD DR
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-8817
Practice Address - Country:US
Practice Address - Phone:330-322-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.13868363LW0102X
OHRN.299720363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health