Provider Demographics
NPI:1265933964
Name:AKEMON, JESSICA K (RN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:K
Last Name:AKEMON
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 1:1058 LANCASHIRE DR
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-2578
Mailing Address - Country:US
Mailing Address - Phone:937-830-0965
Mailing Address - Fax:
Practice Address - Street 1:1058 LANCASHIRE DR
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-2578
Practice Address - Country:US
Practice Address - Phone:937-830-0965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-27
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor