Provider Demographics
NPI:1679059232
Name:FLETCHER, JASON N
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:N
Last Name:FLETCHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:786 CHENOWETH EXT
Mailing Address - Street 2:
Mailing Address - City:NEW FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:44319-2504
Mailing Address - Country:US
Mailing Address - Phone:330-388-5514
Mailing Address - Fax:
Practice Address - Street 1:786 CHENOWETH EXT
Practice Address - Street 2:
Practice Address - City:NEW FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:44319-2504
Practice Address - Country:US
Practice Address - Phone:330-388-5514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide