Provider Demographics
NPI:1689901738
Name:MASDEN, JAMEELIA (LPN)
Entity Type:Individual
Prefix:
First Name:JAMEELIA
Middle Name:
Last Name:MASDEN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4913 GARDEN GREEN WAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-4109
Mailing Address - Country:US
Mailing Address - Phone:502-821-5834
Mailing Address - Fax:
Practice Address - Street 1:4913 GARDEN GREEN WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-4109
Practice Address - Country:US
Practice Address - Phone:502-821-5834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health