Provider Demographics
NPI:1043818479
Name:TROUTMAN, ASJAE'A M
Entity Type:Individual
Prefix:
First Name:ASJAE'A
Middle Name:M
Last Name:TROUTMAN
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 1:1783 E MAIN ST APT 15
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-5819
Mailing Address - Country:US
Mailing Address - Phone:216-299-3559
Mailing Address - Fax:
Practice Address - Street 1:1783 E MAIN ST APT 15
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-5819
Practice Address - Country:US
Practice Address - Phone:216-299-3559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker