| Jennifer D Malek, CNS,BC | |
|
5350 Lamme Rd, Moraine, OH 45439-3215 | |
| (937) 534-4651 | |
| (937) 534-4669 |
| Full Name | Jennifer D Malek |
|---|---|
| Gender | Female |
| Speciality | Certified Clinical Nurse Specialist (cns) |
| Experience | 31 Years |
| Location | 5350 Lamme Rd, Moraine, Ohio |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861659039 | NPI | - | NPPES |
| 0052850 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 364S00000X | Clinical Nurse Specialist | NS01078 (Ohio) | Secondary |
| 364SP0809X | Clinical Nurse Specialist - Psychiatric/mental Health, Adult | APRN.CNS.01078 (Ohio) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Grandview And Southview Hospitals | Dayton, OH | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Kettering Independent Medical Group Inc | 3173710936 | 602 |
| Entity Name | Kettering Independent Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629387865 PECOS PAC ID: 3173710936 Enrollment ID: O20101207000425 |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer D Malek, CNS,BC 3535 Pentagon Blvd Ste 230, Beavercreek, OH 45431-1705 Ph: (855) 500-2873 | Jennifer D Malek, CNS,BC 5350 Lamme Rd, Moraine, OH 45439-3215 Ph: (937) 534-4651 |
Kristina Fisher, MSN,CNS Clinical Nurse Specialist Medicare: Medicare Enrolled Practice Location: 3095 Kettering Blvd, Moraine, OH 45439 Phone: 937-293-8300 Fax: 937-534-1579 | |
Ms. Ladonna J Ross, C.N.S. Clinical Nurse Specialist Medicare: Not Enrolled in Medicare Practice Location: 3095 Kettering Blvd, Moraine, OH 45439 Phone: 937-293-8300 |