Most Relevant Information
Provider Data
| NPI Number: | 1003206913 |
| Provider Name: | JENNIFER NICOLE RIVCHUN MSN, FNP-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | COA.16939-NP |
Most Important Dates
| Enumeration Date: | 01/29/2015 |
| Last Updated: | 06/23/2021 |
Provider Practice Location
28100 CHAGRIN BLVD
WOODMERE
OH
441224522
Practice Location Phone/Fax
| Phone: | 2168311466 |
| Fax: |
Provider Mailing Location
28100 CHAGRIN BLVD
WOODMERE
OH
441224522
Provider Mailing Phone/Fax
| Phone: | 8663892727 |
| Fax: |