| Jacqueline S Shriver, CRNP | |
|
1140 S Knoxville Ave Ste B, Saint Marys, OH 45885-2609 | |
| (419) 394-7314 | |
| (419) 394-7313 |
| Full Name | Jacqueline S Shriver |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Women's Health |
| Location | 1140 S Knoxville Ave Ste B, Saint Marys, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083606610 | NPI | - | NPPES |
| 9934723 | Other | OH | GROUP MEDICARE |
| 1184652539 | Other | OH | GROUP NPI |
| 0742307 | Medicaid | OH | |
| H561340 | Other | OH | MEDICARE PTAN |
| 0105065 | Other | OH | MEDICAID GROUP |
| 34-1689161 | Other | OH | GROUP TAX ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LW0102X | Nurse Practitioner - Women's Health | NP2122 (Ohio) | Primary |
| Entity Name | Jtdm Family Practice Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184652539 PECOS PAC ID: 2163415837 Enrollment ID: O20040407000863 |
| Mailing Address | Practice Location Address |
|---|---|
| Jacqueline S Shriver, CRNP 200 Saint Clair Ave, Saint Marys, OH 45885-2400 Ph: (419) 300-1129 | Jacqueline S Shriver, CRNP 1140 S Knoxville Ave Ste B, Saint Marys, OH 45885-2609 Ph: (419) 394-7314 |
Alex Michael Rowen, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 200 Saint Clair Ave, Saint Marys, OH 45885 Phone: 419-394-3335 | |
Kimberly Lynn Sadler, APRN CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1050 East Greenville Rd, Saint Marys, OH 45885 Phone: 419-394-3331 Fax: 419-394-3330 | |
Brittany Faye Schlarman, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1140 S Knoxville Ave Ste C, Saint Marys, OH 45885 Phone: 419-394-9595 Fax: 419-394-9532 | |
Amanda Leigh Perry, AG-ACNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 200 Saint Clair Ave Ste 101, Saint Marys, OH 45885 Phone: 419-394-9522 Fax: 419-394-9523 | |
Jayaben D Patel, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1140 S Knoxville Ave Ste A, Saint Marys, OH 45885 Phone: 419-394-9959 Fax: 419-394-0255 | |
Mrs. Kimberly Wiener, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 200 Saint Clair Ave, Saint Marys, OH 45885 Phone: 419-890-7970 Fax: 419-394-9556 |