Provider Demographics
NPI:1760253074
Name:NELSON, JASHAE RENEE
Entity Type:Individual
Prefix:
First Name:JASHAE
Middle Name:RENEE
Last Name:NELSON
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 1:116 GLENDALE CT
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-5030
Mailing Address - Country:US
Mailing Address - Phone:440-371-5864
Mailing Address - Fax:
Practice Address - Street 1:116 GLENDALE CT
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-5030
Practice Address - Country:US
Practice Address - Phone:440-452-9703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty