| Doctor Name: | MRS. JENNIFER LYNN BROCKMEYER |
| NPI Number: | 1073952446 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | COA-15761-NP |
| Business Practice Address: | 575 Copeland Mill Rd Suite 1d Westerville, OH - 430818977 |
| Business Phone Number: | 6147940481 |
| Business Fax Number: | 6147943711 |
| Mailing Address: | 575 Copeland Mill Rd, Suite 1d WESTERVILLE |
| State: | OH |
| Postal Code: | 430818977 |
| Phone Number: | 6147940481 |
| Fax Number: | 6147943711 |
| NPI Enumeration Date: | 06/19/2013 |
| NPI Last Update Date: | 10/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261Q00000X |
| License Number: | COA-15761-NP |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |