Provider Demographics
NPI:1316356686
Name:MCMASTERS, JODI SUE (CSFA)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:SUE
Last Name:MCMASTERS
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 SMITHFIELD ST
Mailing Address - Street 2:
Mailing Address - City:DILLONVALE
Mailing Address - State:OH
Mailing Address - Zip Code:43917-6804
Mailing Address - Country:US
Mailing Address - Phone:740-219-2819
Mailing Address - Fax:
Practice Address - Street 1:99 SMITHFIELD ST
Practice Address - Street 2:
Practice Address - City:DILLONVALE
Practice Address - State:OH
Practice Address - Zip Code:43917-6804
Practice Address - Country:US
Practice Address - Phone:740-219-2819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
131226374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician
Provider Identifiers
StateIdentifier IDID TypeIssuer
131226OtherCERTIFIED SURGICAL FIRST ASSISTANT