Provider Demographics
NPI:1558379198
Name:MJ NURSING REGISTRY, INC
Entity Type:Organization
Organization Name:MJ NURSING REGISTRY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:STUMPF
Authorized Official - Suffix:
Authorized Official - Credentials:RN/BSN
Authorized Official - Phone:513-961-1000
Mailing Address - Street 1:2534 VICTORY PKWY
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-2004
Mailing Address - Country:US
Mailing Address - Phone:513-961-1000
Mailing Address - Fax:513-872-7550
Practice Address - Street 1:2534 VICTORY PKWY
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-2004
Practice Address - Country:US
Practice Address - Phone:513-961-1000
Practice Address - Fax:513-872-7550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0717102Medicaid
OH0612126Medicaid
OH367296Medicare ID - Type Unspecified
OH0717102Medicaid