Jasmine Anderson

Individual provider Active NPI Licensed Practical Nurse · Maple Heights, OH

NPI 1316370489 · NPPES record last updated Aug 13, 2013

Key facts

NPI
1316370489
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PN151351 (OH)
Practice address
16233 Edgewood CT
Maple Heights, OH 44137-3967
Phone
(216) 641-3890
NPI assigned
Aug 13, 2013
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PN151351OHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN151351 OH Yes

Addresses

Primary practice location

16233 Edgewood CT
Maple Heights, OH 44137-3967

Mailing address

16233 Edgewood Court
Maple Heights, OH 44137
Phone (216) 641-3890

Other providers in Maple Heights, OH

All providers in Maple Heights, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.