Provider Demographics
NPI:1508163502
Name:JIMMISON, NORMA J (RN)
Entity Type:Individual
Prefix:MS
First Name:NORMA
Middle Name:J
Last Name:JIMMISON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3850 GRENVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44118-3734
Mailing Address - Country:US
Mailing Address - Phone:216-527-7400
Mailing Address - Fax:
Practice Address - Street 1:3850 GRENVILLE RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44118-3734
Practice Address - Country:US
Practice Address - Phone:216-527-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRP209957251J00000X
302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No302F00000XManaged Care OrganizationsExclusive Provider Organization