Provider Demographics
NPI:1932702768
Name:SCHMIDLIN, JEANNE A
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:A
Last Name:SCHMIDLIN
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 1:1935 KIMBERLY DR
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-4224
Mailing Address - Country:US
Mailing Address - Phone:330-678-1853
Mailing Address - Fax:
Practice Address - Street 1:695 DORAMOR ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-2630
Practice Address - Country:US
Practice Address - Phone:330-678-1853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2772174Medicaid