Provider Demographics
NPI:1326790866
Name:JAMISON, ROSE
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:JAMISON
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 1:315 PASCO MONTRA RD
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365-8553
Mailing Address - Country:US
Mailing Address - Phone:937-622-5702
Mailing Address - Fax:
Practice Address - Street 1:315 PASCO MONTRA RD
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365-8553
Practice Address - Country:US
Practice Address - Phone:937-622-5702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant