Provider Demographics
NPI:1093430571
Name:JAMES, JEFFREY CARROLL (CNP)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:CARROLL
Last Name:JAMES
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24700 LORAIN RD
Mailing Address - Street 2:
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-2088
Mailing Address - Country:US
Mailing Address - Phone:440-835-1445
Mailing Address - Fax:440-835-1537
Practice Address - Street 1:1959 COOPER FOSTER PARK RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001-1207
Practice Address - Country:US
Practice Address - Phone:440-434-6565
Practice Address - Fax:440-434-6555
Is Sole Proprietor?:No
Enumeration Date:2022-10-07
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0032468363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health