Provider Demographics
NPI:1659265726
Name:JENNINGS, ALVIN LYNN
Entity type:Individual
Prefix:
First Name:ALVIN
Middle Name:LYNN
Last Name:JENNINGS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44504-1728
Mailing Address - Country:US
Mailing Address - Phone:330-765-5480
Mailing Address - Fax:330-594-2401
Practice Address - Street 1:1350 5TH AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44504-1728
Practice Address - Country:US
Practice Address - Phone:330-765-5480
Practice Address - Fax:330-594-2401
Is Sole Proprietor?:No
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker