Provider Demographics
NPI:1609210939
Name:JESSIKA STURGILL
Entity Type:Organization
Organization Name:JESSIKA STURGILL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:
Authorized Official - First Name:JESSIKA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:STURGILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-805-6924
Mailing Address - Street 1:238 TIMBER HILL DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-6637
Mailing Address - Country:US
Mailing Address - Phone:513-805-6924
Mailing Address - Fax:
Practice Address - Street 1:238 TIMBER HILL DR
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-6637
Practice Address - Country:US
Practice Address - Phone:513-805-6924
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-17
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN133503-M-IV314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility