Justina Jayne Prima, RN
Individual provider Active NPI Registered Nurse · Perrysville, OH
NPI 1346479565 · NPPES record last updated Oct 1, 2009
Key facts
- NPI
- 1346479565
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 316335 (OH)
- Practice address
- 2280 County Road 775
Perrysville, OH 44864-9725 - Phone
- (419) 368-8354
- NPI assigned
- Jul 9, 2009
- 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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 316335 | OH | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 316335 | OH | Yes |
Addresses
Primary practice location
2280 County Road 775
Perrysville, OH 44864-9725
Mailing address
2280 County Road 775
Perrysville, OH 44864-9725
Phone (419) 368-8354
Other providers in Perrysville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.