Provider Demographics
NPI:1518313295
Name:BATTLE, JEWEL LYNN
Entity Type:Individual
Prefix:
First Name:JEWEL
Middle Name:LYNN
Last Name:BATTLE
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 1:1105 KENMORE BLVD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44314-2116
Mailing Address - Country:US
Mailing Address - Phone:419-612-8729
Mailing Address - Fax:
Practice Address - Street 1:1105 KENMORE BLVD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44314-2116
Practice Address - Country:US
Practice Address - Phone:419-612-8729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0161053Medicaid