Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jessica Lynn Ullery, CNP

Individual provider Women's Health Nurse Practitioner · NPI 1063071520

Jessica Lynn Ullery, CNP is a Nurse Practitioner in Beavercreek, Ohio. Qualified in 2018, 8 years ago. Practices with Kettering Independent Medical Group Inc, a 700-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
8
Licensed in
OH
In the registry since
2019
What do these letters mean?
CNP — Certified Nurse Practitioner
A certified nurse practitioner.

See every abbreviation used in this directory →

Practice location Address checks out

3535 Pentagon Blvd Ste 220
Beavercreek, OH 45431-1705
Phone: (937) 429-7350
Fax: (937) 431-2623
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Women's Health Nurse Practitioner (primary) Taxonomy 363LW0102X · Licence APRN.CNP.024578 (OH)

Record details

NPI number1063071520
Entity typeIndividual (Type 1)
GenderFemale
Credentials CNP
Sole proprietorNo
NPI enumeratedJune 10, 2019
Last updated in NPPESNovember 17, 2020
Certification dateNovember 17, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Kettering Independent Medical Group Inc — 700 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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