Provider Demographics
NPI:1003691411
Name:JARVIS, ROSEANNE
Entity Type:Individual
Prefix:
First Name:ROSEANNE
Middle Name:
Last Name:JARVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27081 SHIRLEY AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-2044
Mailing Address - Country:US
Mailing Address - Phone:216-312-7335
Mailing Address - Fax:
Practice Address - Street 1:27081 SHIRLEY AVE
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-2044
Practice Address - Country:US
Practice Address - Phone:216-312-7335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker