Provider Demographics
NPI:1467936542
Name:GADSEN, JASMINE J
Entity Type:Individual
Prefix:MS
First Name:JASMINE
Middle Name:J
Last Name:GADSEN
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 1:1547 TANGELO DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32305-6960
Mailing Address - Country:US
Mailing Address - Phone:850-692-1649
Mailing Address - Fax:
Practice Address - Street 1:1547 TANGELO DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32305-6960
Practice Address - Country:US
Practice Address - Phone:850-692-1649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL18000046252251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health