| Doctor Name: | JENNIFER LYNNE DATTA |
| NPI Number: | 1083676969 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | 10801-NP |
| Business Practice Address: | 3124 Bean Oller Rd Delaware, OH - 430159220 |
| Business Phone Number: | 7403696516 |
| Business Fax Number: | |
| Mailing Address: | 3124 Bean Oller Rd, DELAWARE |
| State: | OH |
| Postal Code: | 430159220 |
| Phone Number: | 7403696516 |
| Fax Number: | |
| NPI Enumeration Date: | 04/05/2006 |
| NPI Last Update Date: | 12/26/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 10801-NP |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |