Provider Demographics
NPI:1952815367
Name:CARNEY, JAYMA CORINNE
Entity Type:Individual
Prefix:
First Name:JAYMA
Middle Name:CORINNE
Last Name:CARNEY
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 1:171 MANZANA CT NW APT 2C
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:MI
Mailing Address - Zip Code:49534-7130
Mailing Address - Country:US
Mailing Address - Phone:248-804-6184
Mailing Address - Fax:
Practice Address - Street 1:171 MANZANA CT NW APT 2C
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:MI
Practice Address - Zip Code:49534-7130
Practice Address - Country:US
Practice Address - Phone:248-804-6184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer