Provider Demographics
NPI:1710698196
Name:GARCIA, JEFFREY SR (LPN)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:GARCIA
Suffix:SR
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5275 N ABBE RD
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44035-1451
Mailing Address - Country:US
Mailing Address - Phone:440-934-9158
Mailing Address - Fax:
Practice Address - Street 1:5275 N ABBE RD
Practice Address - Street 2:
Practice Address - City:SHEFFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44035-1451
Practice Address - Country:US
Practice Address - Phone:440-934-9158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH097839.MEDS164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse