Provider Demographics
NPI:1235912650
Name:WHITEHEAD, JAIMEY LYNN
Entity Type:Individual
Prefix:MRS
First Name:JAIMEY
Middle Name:LYNN
Last Name:WHITEHEAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JAIMEY
Other - Middle Name:LYNN
Other - Last Name:NOLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7200 NOLL DR
Mailing Address - Street 2:
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-3759
Mailing Address - Country:US
Mailing Address - Phone:440-281-5062
Mailing Address - Fax:
Practice Address - Street 1:7200 NOLL DR
Practice Address - Street 2:
Practice Address - City:NORTH RIDGEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44039-3759
Practice Address - Country:US
Practice Address - Phone:440-281-5062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401798381015374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide