Provider Demographics
NPI:1134338684
Name:JERGER, AMY L (RN)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:JERGER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1728 DOUGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44904-1807
Mailing Address - Country:US
Mailing Address - Phone:419-774-4539
Mailing Address - Fax:419-774-4590
Practice Address - Street 1:555 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-1502
Practice Address - Country:US
Practice Address - Phone:419-774-4539
Practice Address - Fax:419-774-4590
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.209743163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health