Provider Demographics
NPI:1457924078
Name:CEASOR, JARRAD
Entity Type:Individual
Prefix:
First Name:JARRAD
Middle Name:
Last Name:CEASOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 CHESTNUT LN
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44143-1057
Mailing Address - Country:US
Mailing Address - Phone:216-400-4768
Mailing Address - Fax:
Practice Address - Street 1:145 CHESTNUT LN APT G407
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44143-1091
Practice Address - Country:US
Practice Address - Phone:216-400-4768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide