Provider Demographics
NPI:1902415292
Name:JAMES, JESSICA CAROL
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:CAROL
Last Name:JAMES
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 1:4185 PRESIDENT DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45225-1023
Mailing Address - Country:US
Mailing Address - Phone:513-968-7511
Mailing Address - Fax:
Practice Address - Street 1:4185 PRESIDENT DR # DE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45225-1023
Practice Address - Country:US
Practice Address - Phone:513-968-7511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide