Provider Demographics
NPI:1376201434
Name:CLEMENTS, JAYNA MARIE
Entity Type:Individual
Prefix:
First Name:JAYNA
Middle Name:MARIE
Last Name:CLEMENTS
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 1:1063 YAPLE RD
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:OH
Mailing Address - Zip Code:45644-9560
Mailing Address - Country:US
Mailing Address - Phone:740-637-7194
Mailing Address - Fax:
Practice Address - Street 1:721 COX AVE # NA
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-3661
Practice Address - Country:US
Practice Address - Phone:740-637-7194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health