Provider Demographics
NPI:1184750366
Name:MCDONALD, JOCELYN MARIA
Entity type:Individual
Prefix:MS
First Name:JOCELYN
Middle Name:MARIA
Last Name:MCDONALD
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 1:2236 MARCIA DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43211-1946
Mailing Address - Country:US
Mailing Address - Phone:614-478-5181
Mailing Address - Fax:614-478-8445
Practice Address - Street 1:2236 MARCIA DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43211-1946
Practice Address - Country:US
Practice Address - Phone:614-478-5181
Practice Address - Fax:614-478-8445
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2709715Medicaid