Provider Demographics
NPI:1962959445
Name:SPEZIALE, JENNA E (CNP, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:JENNA
Middle Name:E
Last Name:SPEZIALE
Suffix:
Gender:F
Credentials:CNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7206 MARKET ST STE A
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-4562
Mailing Address - Country:US
Mailing Address - Phone:330-726-3379
Mailing Address - Fax:330-726-8683
Practice Address - Street 1:7206 MARKET ST STE A
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512
Practice Address - Country:US
Practice Address - Phone:330-726-3379
Practice Address - Fax:330-726-8683
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.361461163W00000X
OHAPRN.CNP.019432363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse