Provider Demographics
NPI:1417102898
Name:JARRETT, CATHERINE
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:JARRETT
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 1:4744 BAYARD RD
Mailing Address - Street 2:
Mailing Address - City:HOMEWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44643
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4744 BAYARD ST
Practice Address - Street 2:
Practice Address - City:HOMEWORTH
Practice Address - State:OH
Practice Address - Zip Code:44634-9751
Practice Address - Country:US
Practice Address - Phone:330-525-7843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-26
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2715833Medicaid