MRS. JENNIFER SUNDSTROM CNP NPI 1528420650

NPI Information

NPI: 1528420650
Provider Name: MRS. JENNIFER SUNDSTROM, CNP
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Individual

Specialization: Primary Care

Organization: ALLIANCE PHYSICIANS INC

PECOS Registration: Yes

Address:
3737 SOUTHERN BLVD STE 2000
KETTERING, OH
ZIP 45429
Phone: (937) 228-4126
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MRS. Jennifer Sundstrom, CNP is a primary care nurse practitioner in Kettering, OH with 9 years of experience. MRS. Jennifer Sundstrom, CNP NPI is 1528420650. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3737 SOUTHERN BLVD STE 2000
KETTERING, OH
ZIP 45429-285
Phone: (937) 228-4126
Fax: (937) 228-0247

The NPI 1528420650 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/28/2016 and was last updated on 3/8/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LG0600X	Nurse Practitioner	Gerontology	RN.273729	OHIO	No
2	363LP2300X	Nurse Practitioner	Primary Care	RN.273729	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0165479	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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