Provider Demographics
NPI:1609629500
Name:JASIK, TRISHA (CENA)
Entity Type:Individual
Prefix:MRS
First Name:TRISHA
Middle Name:
Last Name:JASIK
Suffix:
Gender:F
Credentials:CENA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 MERCER ST
Mailing Address - Street 2:
Mailing Address - City:ESSEXVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48732-1351
Mailing Address - Country:US
Mailing Address - Phone:989-280-1480
Mailing Address - Fax:
Practice Address - Street 1:1506 MERCER ST
Practice Address - Street 2:
Practice Address - City:ESSEXVILLE
Practice Address - State:MI
Practice Address - Zip Code:48732-1351
Practice Address - Country:US
Practice Address - Phone:989-280-1480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty
No376K00000XNursing Service Related ProvidersNurse's Aide