Provider Demographics
NPI:1851181721
Name:ELLIOTT, JENNIFER THERESA
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:THERESA
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2451 ROE DR
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-8664
Mailing Address - Country:US
Mailing Address - Phone:614-430-0644
Mailing Address - Fax:
Practice Address - Street 1:2451 ROE DR
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035-8664
Practice Address - Country:US
Practice Address - Phone:614-430-0644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care