Provider Demographics
NPI:1609449321
Name:SNOW, JESSE J
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:J
Last Name:SNOW
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 1:5616 SMITH RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:OH
Mailing Address - Zip Code:45333-8609
Mailing Address - Country:US
Mailing Address - Phone:937-538-7310
Mailing Address - Fax:
Practice Address - Street 1:5616 SMITH RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:OH
Practice Address - Zip Code:45333-8609
Practice Address - Country:US
Practice Address - Phone:937-538-7310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide