Provider Demographics
NPI:1346995479
Name:JEWS, JAZMICA NICOLE
Entity Type:Individual
Prefix:
First Name:JAZMICA
Middle Name:NICOLE
Last Name:JEWS
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 1:432 PASADENA PL
Mailing Address - Street 2:
Mailing Address - City:BARBERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-4082
Mailing Address - Country:US
Mailing Address - Phone:234-565-8266
Mailing Address - Fax:
Practice Address - Street 1:432 PASADENA PL
Practice Address - Street 2:
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-4082
Practice Address - Country:US
Practice Address - Phone:234-565-8266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH07162015Medicaid