Provider Demographics
NPI:1205343894
Name:CARMAN, JAMIE MICHELLE (LPN)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:MICHELLE
Last Name:CARMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9955 UNION RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:OH
Mailing Address - Zip Code:44455-9763
Mailing Address - Country:US
Mailing Address - Phone:330-822-0148
Mailing Address - Fax:
Practice Address - Street 1:9955 UNION RIDGE RD
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:OH
Practice Address - Zip Code:44455-9763
Practice Address - Country:US
Practice Address - Phone:330-822-0148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-04
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.154975.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty