Provider Demographics
NPI:1760198212
Name:BATTEE JACKSON, CORTIA
Entity Type:Individual
Prefix:MS
First Name:CORTIA
Middle Name:
Last Name:BATTEE JACKSON
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 1:4625 RHODE ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-4417
Mailing Address - Country:US
Mailing Address - Phone:330-622-0459
Mailing Address - Fax:
Practice Address - Street 1:4625 RHODE ISLAND DR
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-4417
Practice Address - Country:US
Practice Address - Phone:330-622-0459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide