MRS. JENNIFER L CICCHILLO (NPI# 1750534509) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750534509 |
| Entity Type | Individual |
| Full Name | MRS. JENNIFER L CICCHILLO |
| Credential | N.P.C. |
| Practice Address |
960 Windham Ct Boardman OH 44512-5087 |
| Practice Telephone | 3307263357 |
| Practice Fax Number | 3307261465 |
| Mailing Telephone | 3307263357 |
| Mailing Fax Number | 3307261465 |
| Enumeration Date | 2008-10-24 |
| Last Update Date | 2020-07-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
RX08356 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
08356 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
960 WINDHAM CT |
| City | BOARDMAN |
| State | OH |
| Zip Code | 44512-5087 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134199433 | Lawrence S Goldstein | Internal Medicine | 960 Windham Ct, Suite 1, Boardman, OH 44512-5087 | 2006-01-26 |
| 1801866439 | Rebecca S Bailey | Internal Medicine | 960 Windham Ct, Boardman, OH 44512-5087 | 2006-01-25 |
| 1760452304 | Ritha Kartan | Internal Medicine | 960 Windham Ct, Suite 1, Boardman, OH 44512-5087 | 2006-01-25 |
| 1235117276 | Eastern Ohio Pulmonary Consultants Inc | Internal Medicine | 960 Windham Ct, Suite 1, Boardman, OH 44512-5087 | 2006-01-09 |
| 1093793689 | Manuel M Bautista | Internal Medicine | 960 Windham Ct, Suite 1, Boardman, OH 44512-5087 | 2006-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285248740 | Kimberly Vrabel | Counselor | 725 Boardman Canfield Road Road Unit 1 and Unit 2, Boardman, OH 44512 | 2020-09-02 |
| 1043830144 | Steffi Lorraine D'souza | Student in an Organized Health Care Education/Training Program | 8423 Market Street Suite 101 St. Elizabeth Boardman Hos, Boardman, OH 44512 | 2020-04-20 |
| 1427677830 | Shivani Sharma | Family Medicine | 8423 Market Street Suite 101, St Elizabeth Boardman Hospital, Boardman, OH 44512 | 2020-04-15 |
| 1417587825 | Ronny Zetts | Pharmacist | 308 Boardman-canfield Rd, Boardman, OH 44512 | 2020-01-24 |
| 1285105080 | Andrew Dawson | Nurse Practitioner | 883 Boardman Canfield Rd Ste 105, Youngstown, OH 44512 | 2018-12-06 |
| 1700374949 | Adam Leid | Student in an Organized Health Care Education/Training Program | St Elizabeth Boardman Hospital - Medical Education Dept, 8401 Market Street, Boardman, OH 44512 | 2018-04-24 |
| 1528574910 | Herman Frank IIi | Licensed Practical Nurse | 920 Boardman Canfield Road, Boardman, OH 44512 | 2017-12-20 |
| 1730601980 | Stephanie Ann Mathews | Nurse Practitioner | 7600 Southern Blvd #1, Boardman, OH 44512 | 2017-07-10 |
| 1417485079 | Telka Ghobadi | Family Medicine | 8423 Market St., Suite 101, Boardman, OH 44512 | 2017-05-26 |
| 1356797534 | Haroon Hussain Syed | Student in an Organized Health Care Education/Training Program | 8423 Market Street, St. Elizabeth Boardman Hospital, Boardman, OH 44512 | 2016-05-06 |
| Find all providers in zip 44512 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467091751 | Mark James Colaluca | Nurse Practitioner | 835 Mckay Ct Ste 100, Boardman, OH 44512-5786 | 2020-01-03 |
| 1770092900 | Teresa Marie Shaffer | Nurse Practitioner | 987 Boardman Canfield Rd, Boardman, OH 44512-4222 | 2017-09-20 |
| 1558767889 | Amanda Sue Mccormick | Nurse Practitioner | 8401 Market St, Boardman, OH 44512-6725 | 2014-11-13 |
| 1326460205 | Amanda Rae Davis | Nurse Practitioner | 8401 Market St, Boardman, OH 44512 | 2014-01-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891394235 | Lisa Ann Popovich | Nurse Practitioner | 3703 Canon Ridge Pl, Columbus, OH 43230-4010 | 2020-10-17 |
| 1598362402 | Kate Suzanne Mccombs | Nurse Practitioner | 6681 Ridge Rd Ste 30, Parma, OH 44129-5705 | 2020-10-04 |
| 1013523745 | Yangyang Hu | Nurse Practitioner | 2042 Golden Oaks Dr, Kent, OH 44240-8198 | 2020-09-17 |
| 1659982494 | Lauren Rainey | Nurse Practitioner | 70 N Hillside Rd, Canfield, OH 44406-1335 | 2020-08-14 |
| 1932710928 | Bobbie Duda | Nurse Practitioner | 6454 Paine Rd, Painesville, OH 44077-9318 | 2020-08-12 |
| 1235756461 | Sara Mauk | Nurse Practitioner | 6780 Mayfield Rd Rm 323, Mayfield Heights, OH 44124-2203 | 2020-07-04 |
| 1629694153 | Laraine Elizabeth Tench | Nurse Practitioner | 9500 Euclid Ave # G110, Cleveland, OH 44195-0001 | 2020-06-20 |
| 1316563109 | Isabelle Noffsinger | Nurse Practitioner | 6443 Far Hills Ave, Washington Township, OH 45459-2725 | 2020-06-17 |
| 1497375604 | Allison Ferguson | Nurse Practitioner | 3641 Shepherd St Nw, North Canton, OH 44720-7949 | 2020-04-17 |
| 1154940708 | Elizabeth Clare Gaydosh | Nurse Practitioner | 4680 Autumn Run Dr, Medina, OH 44256-8821 | 2020-04-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.