Provider Demographics
NPI:1851670632
Name:BRUSH, JAMI LYNN (LPN)
Entity Type:Individual
Prefix:
First Name:JAMI
Middle Name:LYNN
Last Name:BRUSH
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 1:880 GARVER RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-8923
Mailing Address - Country:US
Mailing Address - Phone:513-846-7269
Mailing Address - Fax:
Practice Address - Street 1:880 GARVER RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-8923
Practice Address - Country:US
Practice Address - Phone:513-846-7269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.N.136743164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse