Provider Demographics
NPI:1568812527
Name:WHITE, JAMAESIA
Entity Type:Individual
Prefix:
First Name:JAMAESIA
Middle Name:
Last Name:WHITE
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 1:1089 MATTHEWS DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-1859
Mailing Address - Country:US
Mailing Address - Phone:513-328-8678
Mailing Address - Fax:
Practice Address - Street 1:1089 MATTHEWS DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215-1859
Practice Address - Country:US
Practice Address - Phone:513-772-0484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH173000164W00000X
OH401526890513376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty